A 58-year-old postmenopausal woman presents with abnormal vaginal bleeding and a pelvic mass. Laparotomy reveals a solid-cystic right ovarian tumor, 8 cm, with no surface involvement, no ascites, and no peritoneal deposits. Frozen section suggests a granulosa cell tumor. What is the appropriate surgical management?

• A Unilateral salpingo-oophorectomy with close follow-up
• B Total abdominal hysterectomy with bilateral salpingo-oophorectomy
• C Surgical staging with peritoneal washings, biopsies, omentectomy, and pelvic/para-aortic lymph node sampling ✓
• D Cytoreductive surgery with optimal tumor debulking

Explanation

Granulosa cell tumors are sex cord-stromal tumors managed with comprehensive surgical staging similar to epithelial ovarian cancer, including peritoneal washings, omental biopsy, peritoneal biopsies, and lymph node assessment. Hysterectomy and BSO are included in staging but are not sufficient alone. Adjuvant chemotherapy is reserved for advanced-stage disease. Late recurrence is characteristic, making long-term follow-up essential.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.