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Adult granulosa cell tumor presenting with massive ascites, elevated CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

Tak JY, Chong GO, Park JY, Lee SJ, Lee YH, Hong DG - Obstet Gynecol Sci (2015)

Bottom Line: Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature.An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer.In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

No MeSH data available.


Related in: MedlinePlus

(A) Computed tomography showing a 15×14×13 cm3 well-defined solid pelvic mass including a cystic component (arrow) with massive ascites. (B) 18F-fluorodeoxyglucose positron emission tomography/computed tomography showing low peripheral 18F-fluorodeoxyglucose uptake (maximum standardized uptake value 2.1, arrow).
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Figure 1: (A) Computed tomography showing a 15×14×13 cm3 well-defined solid pelvic mass including a cystic component (arrow) with massive ascites. (B) 18F-fluorodeoxyglucose positron emission tomography/computed tomography showing low peripheral 18F-fluorodeoxyglucose uptake (maximum standardized uptake value 2.1, arrow).

Mentions: A 55-year-old postmenopausal woman was admitted to our hospital with a 1-month history of abdominal fullness and dyspnea. She had no specific medical or surgical history. An ultrasound revealed massive ascites and a heterogeneous mass measuring 15×14×13 cm3 in the lower abdomen. Computed tomography (CT) also revealed a well-defined solid pelvic mass including a cystic component measuring 15×14×13 cm3 arising from the left adnexa (Fig. 1A). 18F-FDG PET/CT showed low peripheral 18F-FDG uptake (SUVmax 2.1) (Fig. 1B). CT and 18F-FDG PET/CT showed no evidence of metastatic disease involving the lymph nodes or abdominal organs. The serum CA-125 concentration was 220.5 U/mL (upper limit, 35 U/mL). The serum levels of carcinoembryonic antigen and CA-19-9 were normal. An explorative laparotomy was performed based on the suspicion of ovarian cancer. The left ovary was replaced by a mass measuring 14×13×12 cm3, and 5,000 mL serous ascites fluid was aspirated from the abdomen. The liver, spleen, bilateral paracolic gutters, bowel, and the space beneath the diaphragm were all free of tumor. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and paraaortic lymphadenectomy were performed. Intraoperative cytology was also performed. Frozen section from tumor specimen showed sex cord stromal tumor which was suggestive of granulosa cell tumor.


Adult granulosa cell tumor presenting with massive ascites, elevated CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

Tak JY, Chong GO, Park JY, Lee SJ, Lee YH, Hong DG - Obstet Gynecol Sci (2015)

(A) Computed tomography showing a 15×14×13 cm3 well-defined solid pelvic mass including a cystic component (arrow) with massive ascites. (B) 18F-fluorodeoxyglucose positron emission tomography/computed tomography showing low peripheral 18F-fluorodeoxyglucose uptake (maximum standardized uptake value 2.1, arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588851&req=5

Figure 1: (A) Computed tomography showing a 15×14×13 cm3 well-defined solid pelvic mass including a cystic component (arrow) with massive ascites. (B) 18F-fluorodeoxyglucose positron emission tomography/computed tomography showing low peripheral 18F-fluorodeoxyglucose uptake (maximum standardized uptake value 2.1, arrow).
Mentions: A 55-year-old postmenopausal woman was admitted to our hospital with a 1-month history of abdominal fullness and dyspnea. She had no specific medical or surgical history. An ultrasound revealed massive ascites and a heterogeneous mass measuring 15×14×13 cm3 in the lower abdomen. Computed tomography (CT) also revealed a well-defined solid pelvic mass including a cystic component measuring 15×14×13 cm3 arising from the left adnexa (Fig. 1A). 18F-FDG PET/CT showed low peripheral 18F-FDG uptake (SUVmax 2.1) (Fig. 1B). CT and 18F-FDG PET/CT showed no evidence of metastatic disease involving the lymph nodes or abdominal organs. The serum CA-125 concentration was 220.5 U/mL (upper limit, 35 U/mL). The serum levels of carcinoembryonic antigen and CA-19-9 were normal. An explorative laparotomy was performed based on the suspicion of ovarian cancer. The left ovary was replaced by a mass measuring 14×13×12 cm3, and 5,000 mL serous ascites fluid was aspirated from the abdomen. The liver, spleen, bilateral paracolic gutters, bowel, and the space beneath the diaphragm were all free of tumor. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and paraaortic lymphadenectomy were performed. Intraoperative cytology was also performed. Frozen section from tumor specimen showed sex cord stromal tumor which was suggestive of granulosa cell tumor.

Bottom Line: Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature.An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer.In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low (18)F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.

No MeSH data available.


Related in: MedlinePlus