Liver metastasis of ovarian granulosa cell tumors: A case report and literature review

Background：Granulosa cell tumors (GCT) are a distinct type of sex cord-stromal tumor with low-grade malignancy. It frequently recurs due to pelvic dissemination or direct spread, whereas liver metastasis rarely occurs. Here, we report a rare case of a GCT in which recurrence with liver metastasis occurred 14 years later. We also discuss the imaging findings, histological features, and therapeutic approaches, and conducted a review of similar reported cases. Case presentation： A 61-year-old female presented with a 14-year history of ovarian tumor resection for GCT. She was admitted to our hospital due to complaints of epigastric distension and acid regurgitation. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a hepatic mass measuring approximately 8 cm in diameter. Following surgical resection, histopathological examination of the sample revealed tumor cells with "coffee-bean-like" nuclei, a characteristic feature of GCT. Additionally, eosinophilicunstructured Call-Exner bodies were observed. Immunohistochemical analysis confirmed positive immunoreactivity for the inhibin α, CD99 and CD56 markers. On the basis of these findings, the tumor was diagnosed as a hepatic metastasis of an ovarian GCT. The patient remained recurrence-free for 7 years following hepatic resection. Conclusions：Herein, we report a rare case of hepatic metastasis derived from a GCT that was diagnosed 14 years after initial oophorectomy. This case highlights the potential for late recurrence of ovarian GCT, even in the decades following primary treatment. Close long-term follow-up is essential to detect recurrence early and optimize patient outcomes.