Granulosa cell tumor

After the care team diagnoses a granulosa cell tumor, the next step is to find the cancer's stage. The stage tells how far the granulosa cell tumor has spread. This helps the care team plan treatment. It also plays a role in prognosis, which means how likely it is the cancer can be treated or cured.

Granulosa cell tumor stages range from 1 to 4. A lower stage means the cancer is more limited. A higher stage means the cancer has spread beyond the ovary.

Staging tests

To find the stage, your care team uses the results of tests and procedures, including:

• Imaging tests. Tests such as CT and MRI may show if cancer has spread outside the ovary. This information helps decide the stage.
• Surgery and tissue testing. Granulosa cell tumors usually are staged during surgery to remove the tumor. The care team looks for signs that cancer has spread beyond the ovary. The team may collect samples of tissue or fluid from the belly. Later, a pathologist looks at the samples under a microscope to check for cancer cells.

Stage 1

Stage 1 granulosa cell tumor has not spread beyond one or both ovaries or fallopian tubes. Stage 1 is divided into several groups.

• Stage 1A. This means the cancer is in one ovary or fallopian tube only and the tumor has not broken open. It also means there's no cancer on the outside surface of the ovary or fallopian tube. And no cancer cells were found in the fluid sample taken from the belly during surgery.
• Stage 1B. This means the cancer is in both ovaries or fallopian tubes. The rest is the same as stage 1A.
• Stage 1C. This means the cancer is still located only in one or both ovaries or fallopian tubes. But the tumor has broken open before or during surgery. Or cancer is found on the outside surface of an ovary or fallopian tube. Or there were cancer cells in the fluid sample taken from the belly during surgery.

Stage 2

Stage 2 granulosa cell tumor has spread beyond the ovaries or fallopian tubes. Stage 2 is split into two groups.

• Stage 2A. This means the cancer has spread to the uterus, fallopian tubes or both.
• Stage 2B. This means the cancer has spread to other tissues in the pelvis.

Stage 3

Stage 3 granulosa cell tumor has spread outside the pelvis. Stage 3 is split into several groups.

• Stage 3A1. This means the cancer has spread to lymph nodes in the lining of the back of the belly. Lymph nodes are part of a network of vessels and nodes that help drain fluid and fight infection.
• Stage 3A2. This means cancer cells are found on the lining of the back of the belly, but the cancer is still too small to be seen without a microscope. Lymph nodes in the belly also may be affected.
• Stage 3B. This means cancer has spread to the lining of the back of the belly and is big enough to be seen without a microscope but is about 1 inch (2 centimeters) or smaller. Lymph nodes in the belly also may be affected.
• Stage 3C. This means cancer has spread to the lining of the back of the belly and is larger than about 1 inch (2 centimeters). Lymph nodes in the belly also may be affected. Cancer may be on the outer surface of the liver or spleen, too, but not inside these organs.

Stage 4

Stage 4 granulosa cell tumor has spread farther in the body. Stage 4 is split into two groups.

• Stage 4A. This means cancer cells are found in fluid around the lungs.
• Stage 4B. This means cancer has spread to organs farther away, such as inside the liver, spleen, lungs, bones or lymph nodes in areas outside the belly.

How stage affects granulosa cell tumor treatment and prognosis

Stage is an important part of granulosa cell tumor treatment planning. It also affects prognosis for granulosa cell tumor. Stage 1 tumors may be treated with surgery alone. Higher stage tumors, and sometimes stage 1C granulosa cell tumors, may be treated with chemotherapy too.

Stage 1 cancer that is limited to the ovary has a better prognosis than higher stage cancer that's spread past the ovary. Most granulosa cell tumors are found at an early stage.