Management challenges of ovarian adult-type granulosa cell tumors at a tertiary facility in resource-limited setting: A case series of three patients and review of the current literature

Introduction and importance: Adult-type granulosa cell tumors (AGCTs) are rare, low-grade malignant ovarian sex-cord stromal tumors, accounting for approximately 5 % of all ovarian tumors. These tumors are characterized by their potential for late recurrence and complex management, which presents significant challenges, particularly in resource-limited settings where access to advanced diagnostic tools and treatment options is restricted. This study highlights a series of rare AGCT cases diagnosed in premenopausal and postmenopausal women in Northern Tanzania. Given the global rarity of AGCTs and the limited literature on the condition, especially in this region, this study aims to address a critical knowledge gap.

Case series: This report presents a series of three patients diagnosed with ovarian adult-type granulosa cell tumors (AGCTs) based on histological findings. The series underscores the variability in clinical presentations and highlights the significance of individualized treatment approaches in managing these rare tumors.

Clinical discussion: Managing AGCTs in resource-limited settings requires balancing optimal care with available resources. Surgery remains the cornerstone of treatment; however, the lack of advanced diagnostic tools and limited access to adjuvant therapies necessitate a focus on achieving the best possible surgical outcomes and prioritizing rigorous clinical follow-up. This report explores the rarity of AGCTs, reviews existing literature on similar cases, and examines the numerous challenges associated with their management in such settings.

Conclusion: Adult granulosa cell tumors are rare, low-grade malignant neoplasms of the ovarian sex-cord stromal origin. These tumors are notable for their potential to recur even years after initial treatment. Consequently, regular follow-up with clinical examinations and tumor marker assessments is recommended. While chemotherapy can provide palliative benefits and manage recurrence, surgery remains the cornerstone of treatment, as illustrated in our case report.