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had granulosa tumor, now what??

3 weeks ago i started having horrible pains in my stomach. i went to the ER and they did a vaginal US. they found a 6cm mass on my right ovary and immediately did surgery to remove it. it had ruptured and they took my right ovary as well. i went back to the Dr. that performed the surgery 4 days later and he said that he only had the preliminary pathology report and that it was a granulosa tumor, that it was most likely benign, so it wasnt anything to worry to much about. I went back 2 weeks later and he has received the actual path report which indicated that the tumor was malignant. the tumor was on the outside of the ovary and my ovary was 3 times the size of my left one. we do not know how long the tumor was there for and no further testing has been done to determine if it spread to any other parts of my body yet. I was wondering if this means that i have ovarian cancer? and what are the next steps that should be taken?
4 Responses
1242509 tn?1279120864
I am sorry you have to go threw this it is very stressfull to have this hanging over your head. My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 .
GCT are  types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. Granulosa cell tumors often produce estrogen/testosterone, and symptoms related to excessive hormone secretion of either are common. For women who are post menopause and have vag bleed it is due to excessive estrogen. When there is a lack of menses then it is probably due to excessive testosterone but with any cancer nothing is written in stone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca,they are Inhibin A&B and MIS.
Please keep in mind if and only if you have a diagnoses of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing cancerous tumors as opposed to epitheal ovarian cancer. This cancer can possibly never return if removed intact, nodes are clear and pelvic washings were clear along with a low mitotic rate. Or unfortunately it can rear it's ugly head 5,10 and 15 years from now,this will be a life long vigilance.
My wife's Dr's in Sloan Kettering in NYC said she also has nothing to worry about because they removed the ovary fully intact. Removing the ovary fully intact is an indication for possibly no further tumors will develop.(cross our fingers)
Ask your surgeon if your tumor was removed intact. It is very important to find out if this was removed intact because if it was massarated/punctured than seeding of the pelvis is probable. Did the surgeon take any pelvic washings to see if there was any cancer cells in the pelvis.
They also said no further testing is needed. I have her Inhibin A&B done every 6 months. Also important is the mitotic level of the cancer cells being rated on a (1-10) scale, this is an index of how potentially virulent or agressive the cancer cells may be. Dr use that # as a guide to see if they want to do further treatment
Please post if you have any other questions.
Regards,
Kevin

Avatar universal
so what happens if it wasnt removed intact? i got a copy of my OP report and found out that it had not ruptured when he started the surgery, he actually intentionally punctured the tumor and let it bleed out. when he couldnt contain the bleeding he decided to just remove the ovary also. does that mean that he spread the cancer now? i am going to an Oncologist next week, but i really feel like i need more information than i am being given by this doctor.
1242509 tn?1279120864
Besides your op report the trans vag sonogram would have shown wether it ruptured prior to surgey.
  All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal. This is why you see all over these posts to make sure a gyn/oncologist with vast experience remove any suspicious mass or cysts.
Since post surgery path showed it was cancerous and your Dr punctured the mass then unfortunately yes there was spilling of cells. Please get all your pathology results so you can see exactly what he sent to pathology, ie; mass,nodes,ovary/fallopian tube and pelvic washings. YOU WILL NEED TO GO SEE a gyn/oncologist surgeon in a large medical center to make sure you had the correct staging and the need for further debulking surgey.
Please keep me informed and post if you have any further questions.
349465 tn?1289081764
You need to change doctors immediately.   You need to be seeing a GYN/ONCOLOGIST only.

Please let us know how you are doing.
Teresa
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