Surgical resection of a liver metastasis from an ovarian granulosa cell tumor mimicking a simple hepatic cyst.

A 57-year-old woman underwent follow-up after surgery for a right ovarian granulosa cell tumor. Four years after the initial operation, computed tomography (CT) revealed a hepatic lesion suggestive of a simple hepatic cyst. Given that the lesion showed progressive enlargement, liver biopsy was performed, and recurrent hepatic metastasis from an ovarian granulosa cell tumor was diagnosed. She was administered a combination of paclitaxel and carboplatin (TC regimen), followed by bleomycin, etoposide, and cisplatin; however, disease control was not achieved, and para-aortic lymph node metastasis was suspected. As chemotherapy was considered ineffective, surgical resection was planned. Para-aortic lymph node metastasis was confirmed, and para-aortic lymph node dissection was performed, followed by left lateral sectionectomy and partial hepatectomy of segments 5 and 7/8. At 1 year and 4 months postoperatively, CT revealed three cystic hepatic lesions with para-aortic lymphadenopathy, deemed unresectable. TC chemotherapy was ineffective, and the patient died 5 years and 7 months after hepatectomy. Hepatic metastases from ovarian granulosa cell tumors may mimic simple hepatic cysts on imaging. Hepatic recurrence may differ from pelvic recurrence in clinical behavior, and hepatectomy may have a role in patients in whom macroscopic complete resection or symptom relief can be expected, although its survival benefit remains unproven.