Granulosa tumours of the ovary

This page tells you about a rare type of cancer called granulosa tumour of the ovary. You can use the links to go straight to sections on

 
 

Granulosa tumours

Granulosa tumours are rare tumours of the ovary. Out of 100 women with ovarian cancer, less than 5 will have a granulosa tumour.

There are two main types of granulosa tumours

  • Functioning tumours, which produce hormones
  • Non-functioning tumours, which don’t produce hormones

Functioning tumours usually make the female hormone oestrogen, although some tumours make other hormones, including male hormones.

We don’t know what causes this type of cancer. Most cancers are caused by a number of different factors working together. There is more information about causes and cancer in the about cancer section of CancerHelp UK.

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Symptoms of granulosa tumours

The symptoms of functioning tumours are usually related to the hormones they make. These symptoms include

Menstrual changes (periods)

If you are still having periods they may become irregular, they may be very heavy and you may bleed in between periods

Vaginal bleeding

If you have had your menopause the most common symptom is vaginal bleeding. This happens because the hormones the tumour makes the lining of the womb thicker. This means that you may also need some tests to check your womb as well.

Breast tenderness

You may have breast tenderness and vaginal discharge due to the hormones.

Hormonal changes

Most granulosa tumours produce the female hormone oestrogen, but some rare tumours can make the male hormone testosterone. If this happens it can make you have acne, a deeper voice, and facial hair.

Other symptoms of granulosa tumours can include

  • Pain in the tummy (abdomen)
  • Swelling of the abdomen
  • Constipation
  • Passing urine more often than usual
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Treatment for granulosa tumours

The type of treatment you will have will depend on

  • Your age and whether you have been through the menopause
  • Whether you want to have children
  • The stage of your cancer

There are different kinds of treatment for granulosa tumours. You can use the links below to go straight to sections on

Surgery

Surgery is the main treatment for this type of ovarian cancer, and for many women it is the only treatment you need.

If you have had your menopause, you will have your ovaries, fallopian tubes and womb removed. This operation is called a bilateral salpingo-oophorectomy and total abdominal hysterectomy.

If you are still having periods and want to have children, and the tumour is only in one ovary, the surgeon may be able to remove just the ovary affected by the cancer and the fallopian tube on that side. This will leave your womb and the other ovary intact.

During surgery the doctors will also check the rest of your abdominal area for cancer

If the cancer comes back in the same area you may have more surgery, and possibly other treatments too.

Chemotherapy

Doctors use chemotherapy to treat more advanced cancer, or cancer that has come back and can't be removed by surgery.

Generally, you have chemotherapy as a combination of 3 different drugs. Various different combinations are used but they all include a drug known as platinum. One of the more common chemotherapy ‘regimens’ is called BEP. This can also treat testicular cancer. All the drugs go into your bloodstream through a vein in your arm (intravenously) or through a central line.

Radiotherapy

You may have radiotherapy to treat the cancer if it comes back. It isn’t usually used as a first treatment.

After treatment

Women with early stage granulosa tumour have a low risk of the cancer coming back. After treatment your doctor will want to see you regularly. At first this will be every few months but as time goes by it will become less often. This follow up will continue for many years as there is a chance the cancer can come back some years after treatment.

Follow up may involve having a blood test. Doctors use these blood tests to look for a marker in your blood. A marker is a substance produced by cancer cells that can be picked up in blood. The level of the marker goes up as the cancer grows.

A number of different markers can be raised with granulosa tumours. It is important to remember that these markers may be raised for reasons other than cancer. However, checking for these markers, alongside other tests, can sometimes help to check if the cancer has come back.

The markers doctors look at to check for granulosa tumours are inhibin, CA125 and Müllerian-inhibiting substance (MIS). Tests for inhibin and Müllerian-inhibiting substance are not available in all hospitals.

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