The Surgical Odyssey: A Case Report on Rare Isolated Abdominal Wall Recurrence in an Adult Ovarian Granulosa Cell Tumor

A 50-year-old woman with a history of adult granulosa cell tumor (AGCT) of the right ovary was under follow-up after undergoing several surgeries, including a total abdominal hysterectomy with bilateral salpingo-oophorectomy. She was initially diagnosed eight years ago and remained disease-free for 52 months. However, she later experienced a recurrence, indicated by elevated inhibin B levels (58 ng/mL) and the presence of peritoneal soft tissue tumors. Following secondary debulking surgery, histopathology confirmed recurrent granulosa cell tumor (GCT). Although she was advised to undergo hormonal therapy, she was lost to follow-up. After 21 months, she returned with an increased inhibin B level of 82 ng/mL, but imaging showed no signs of recurrence. Following a disease-free interval (DFI) of 23 months, an abdominal lump was discovered, prompting tertiary debulking surgery. During this procedure, cystic lesions were excised, and a large defect in the rectus sheath was repaired using a left rectus abdominis flap, followed by the placement of a mesh. Postsurgery, she received adjuvant chemotherapy consisting of paclitaxel and carboplatin. She had a favorable recovery with no complications during the postoperative period. At the six-month follow-up, her wound had healed well, and she was doing well overall. Isolated recurrent AGCT on the abdominal wall is a very rare presentation and can be managed using debulking surgery, with a multidisciplinary team playing a crucial role.