Prolonged survival following maximal cytoreductive effort for peritoneal metastases from recurrent granulosa cell tumor of the ovary

To the editor: Granulosa cell tumor (GCT) of the ovary is cha rac terized by a relatively indolent natural history with a pro pensity for late recurrence and longterm survival. The median time to recurrence is 4 to 6 years after the initial diagnosis Disease recurrence often presents within the pelvis as a local mass, in the retroperitoneal lymph nodes, or as disseminated peritoneal metastases There is no standard management for recurrent GCT. Various treatment options include surgery with/without chemotherapy and/or radiotherapy. Patients with peritoneal metastases are often considered inoperable with treatment largely directed at palliation of symptoms. Five patients with recurrent GCT with peritoneal metastases from our institution were treated with cytoreductive surgery (CRS).