Is the endometrial evaluation routinely required in patients with adult granulosa cell tumors of the ovary?

Jessica Ottolina, Gabriella Ferrandina, Angiolo Gadducci, Paolo Scollo, Domenica Lorusso, Giorgio Giorda, Enrico Breda, Antonella Savarese, Massimo Candiani, Fulvio Zullo, Giorgia Mangili

Research output: Contribution to journalArticlepeer-review


Objective. Granulosa cell tumors (GCTs) are the most common estrogen-secreting ovarian tumors; perhaps due to the persistent hyperestrogenism, a wide spectrum of associated endometrial pathologies ranging from endometrial hyperplasia to carcinoma has been documented in patients with GCTs. The aim of this study is to evaluate the incidence of endometrial pathologies in a large series of GCT patients treated in MITO centers. Methods. A retrospective multi-institutional review of patients with granulosa cell tumors of the ovary treated or referred to MITO centers was conducted. Descriptive statistics were used to characterize the patient population and to assess the association of GCT and endometrial abnormalities at the time of diagnosis; multivariate regression analysis was also performed to identify independent predictors of endometrial abnormalities. Results. A total of 150 patients with primary adult GCT was identified. During the preoperative assessment, endometrial pathology was found in 35.9% of symptomatic patients and in 90.9% of asymptomatic women with endometrial thickening at transvaginal ultrasound. At the time of surgery, hyperplasia was documented in 29.2% of patients, whereas endometrial cancer occurred in 7.5% of patients. Almost all of the patients (97.6%) with endometrial hyperplasia were older than 40 years. All patients with endometrial cancer were older than 40 years and postmenopausal. Conclusions. Endometrial carcinoma/atypical hyperplasia were commonly observed in GCT patients > 40 years; based on these data, endometrial sampling should be performed in symptomatic women at least 40 years of age. In asymptomatic women <40 years, endometrial sampling is of low yield.

Original languageEnglish
Pages (from-to)230-234
Number of pages5
JournalGynecologic Oncology
Issue number2
Publication statusPublished - Feb 1 2015


  • Endometrial carcinoma
  • Endometrial hyperplasia
  • Endometrial sampling
  • Granulosa cell tumor of the ovary
  • Hyperestrogenism

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology


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