Late Hepatic Recurrence From Granulosa Cell Tumor: A Case Report

Adult granulosa cell tumor (GCT) of the ovary is a rare sex cord-stromal neoplasm characterized by potential for late recurrence. Hepatic metastases from GCT are exceedingly uncommon. We report a case of late hepatic relapse occurring 15 years post primary treatment. A 66-year-old woman with obesity presented with right upper quadrant pain of 1-month duration. She had a history of stage T1aN0M0 right ovarian GCT treated 15 years prior with total abdominal hysterectomy, bilateral oophorectomy, omentectomy, and adjuvant chemotherapy, with no follow-up. Imaging revealed extensive perihepatic and intrahepatic lesions and a midabdominal mass. Laparotomy confirmed an abdominal mass greater than 15 cm and multiple hepatic lesions. Excisional histopathology demonstrated metastatic GCT of the liver and peritoneum. This case emphasizes the need for lifelong surveillance in patients with GCT due to its latent recurrence potential even beyond a decade.