GnRHa as a treatment for letrozole-resistant recurrent adult granulosa cell tumors: A case report

INTRODUCTION: The optimal management of recurrent ovarian granulosa cell tumors is still unknown, and hormone therapy may be an alternative for chemotherapy-resistant cases. PATIENT CONCERNS: A 46-year-old woman presented with a third recurrence after primary treatment of granulosa cell tumors. She developed tumor progression and drug-induced nephritis after 6 cycles of combined treatment with cisplatin and paclitaxel for the second recurrence and failed to benefit from chemotherapy, after the third optimal cytoreduction and tumor progression after 6 months of letrozole treatment. DIAGNOSIS: Letrozole-resistant recurrent ovarian granulosa cell tumors INTERVENTIONS: Intramuscular Diphereline 3.75 mg q28d. OUTCOMES: Computed tomography showed the metastatic neoplasm resolved. Progression-free survival is 20 months. CONCLUSION: Hormone therapy may be an alternative to treat recurrent granulosa cell tumors, and gonadotropin-releasing hormone agonists may be a rescue treatment for aromatase inhibitor-resistant cases.