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The secretion of estradiol is the reason for signs at presentation such as vaginal bleeding and precocious puberty. Abdominal pain and hemoperitoneum, which occasionally can occur, are attributable to tumor rupture. The most common finding in pelvic examination is a tumor mass, which is subsequently confirmed with imaging techniques. Surgery is the mainstay of initial management for histological diagnosis, appropriate staging, and debulking. A more conservative unilateral salpingo-oophorectomy is indicated in patients with stage I disease and patients of reproductive age. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is the appropriate surgical treatment for postmenopausal women and those with more advanced disease. The stage of disease is the most important prognostic factor associated with the risk of relapse. There are no clear conclusions regarding the role of postoperative chemotherapy or radiotherapy in stage I disease and in those with completely resected tumor. The use of adjuvant chemotherapy or radiotherapy has sometimes been associated with prolonged disease-free survival and possibly overall survival. Chemotherapy is the treatment of choice for patients with advanced, recurrent, or metastatic disease, and BEP (bleomycin, etoposide, and cisplatin) is the preferred regimen. Although the overall rate of response to treatment is high, the impact of treatment on disease-free or overall survival is unknown. Prolonged surveillance is mandatory because tumors tend to recur years after the initial diagnosis.<\/jats:p>","DOI":"10.1177\/1534735408322845","type":"journal-article","created":{"date-parts":[[2008,9,24]],"date-time":"2008-09-24T02:07:43Z","timestamp":1222222063000},"page":"204-215","source":"Crossref","is-referenced-by-count":73,"title":["Granulosa Cell Tumor of the Ovary: Tumor Review"],"prefix":"10.1177","volume":"7","author":[{"given":"Georgios V.","family":"Koukourakis","sequence":"first","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilios E.","family":"Kouloulias","sequence":"additional","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Koukourakis","sequence":"additional","affiliation":[{"name":"University of Thrace, Radiation Therapy Unit, Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Zacharias","sequence":"additional","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Papadimitriou","sequence":"additional","affiliation":[{"name":"University of Athens, Medical School, Alexandras Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriaki","family":"Mystakidou","sequence":"additional","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriaki","family":"Pistevou-Gompaki","sequence":"additional","affiliation":[{"name":"University of Thessaloniki, Ahepa Hospital, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kouvaris","sequence":"additional","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Gouliamos","sequence":"additional","affiliation":[{"name":"University of Ahepa Medical School, 2nd Department of Radiology, Radiation Therapy Unit, Attikon University Hospital, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2008,9,1]]},"reference":[{"key":"atypb1","first-page":"231","volume":"55","author":"Evans AT III","year":"1980","journal-title":"Obstet Gynecol"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197501)35:1<231::AID-CNCR2820350128>3.0.CO;2-O"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.10.019"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.3.589"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198408000-00002"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.3109\/15513818809041579"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1988.6.6.990"},{"key":"atypb8","first-page":"40","volume":"113","author":"Biscotti CV","year":"1989","journal-title":"Arch Pathol Lab Med"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199804000-00022"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(81)90040-8"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(83)90083-5"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1994.1010"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1016\/S0936-6555(98)80008-3"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970515)79:10<1951::AID-CNCR16>3.0.CO;2-U"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(79)90090-8"},{"key":"atypb16","first-page":"718","volume":"52","author":"Pankratz E.","year":"1978","journal-title":"Obstet Gynecol"},{"key":"atypb17","first-page":"627","volume":"32","author":"Bennington JL","year":"1968","journal-title":"Obstet Gynecol"},{"key":"atypb18","first-page":"786","volume":"108","author":"Nakashima M.","year":"1984","journal-title":"Arch Pathol Lab Med"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91071-S"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.1060"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(76)90577-9"},{"key":"atypb22","unstructured":"Young RH, Clement PB, Scully RE: The ovary. 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