Dear OncoLink "Ask The Experts,"
My 8-year-old daughter had a malignant granulosa cell tumor removed. I cannot find a doctor who has experience dealing with this type of ovarian cancer in children. I want to have a treatment plan in place in case we have a reoccurrence. I have read that treatment has not been successful for reoccurrences. She scored a 7 on the mit`otic index. I was told she had a 50/50 chance of a reoccurrence with that score. Please help me with any information or guidance you may have. I have searched everywhere with little results. Thank you.
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
You did not mention the stage of your daughter's tumor. Stage of the disease is the most important factor in predicting recurrence--much more important than mitotic index. Patients with stage I tumors limited to the ovary may usually be treated with only surgical removal of that ovary. For patients with juvenile granulosa cell tumors, recurrences have not been reported to occur once three years from the initial diagnosis have passed.
For children with this condition I recommend that consultation with a pediatric oncologist. A specialist at a large children's hospital may have more experience with this tumor than an oncologist who predominantly sees adults.