Diagnostic utility of Mullerian inhibiting substance determination in patients with primary and recurrent granulosa cell tumors

UMMS Affiliation

Department of Pediatrics

Publication Date


Document Type



Adolescent; Adult; Aged; Anti-Mullerian Hormone; Child; Child, Preschool; Female; *Glycoproteins; Granulosa Cell Tumor; Growth Inhibitors; Humans; Middle Aged; *Mullerian Ducts; Neoplasm Recurrence, Local; Ovarian Neoplasms; Retrospective Studies; Testicular Hormones; Tumor Markers, Biological


Cell Biology | Developmental Biology | Endocrinology


OBJECTIVES: In this study we evaluated changes in serum Mullerian inhibiting substance (MIS) concentration in a large number of patients with granulosa cell tumors (GCT) to determine whether MIS is elevated at the time of presentation and whether MIS is an index of successful surgical resection and management of recurrences.

METHODS: We retrospectively reviewed MIS levels from 17 subjects prior to tumor resection and studied serial MIS samples from 56 subjects following initial tumor resection. Clinical follow-up information was available for 36 of those with postoperative MIS values. Serum MIS was measured by an ELISA. MIS values were compared to a combination of normative values previously established in our laboratory and from more recently obtained samples from older pre- and postmenopausal women, using this assay.

RESULTS: Serum MIS was elevated pre-operatively in 6 of 8 (75%) subjects with juvenile GCTs and in 7 of 9 (78%) of those with adult GCTs relative to age-matched controls (76% for both types combined). Post-operative clinical correlation was available for 36 patients. There was no clinical recurrence in 21 subjects with normal or undetectable postoperative values, and incompletely resectable tumor or recurrence was identified in 6 of 15 patients with elevated postoperative values.

CONCLUSIONS: The results of this study demonstrate that postoperative serum MIS concentrations may be used to evaluate the completeness of tumor removal following initial surgery and that serial MIS determinations may allow the detection of recurrences.

DOI of Published Version



Gynecol Oncol. 1999 Apr;73(1):51-5. Link to article on publisher's site

Journal/Book/Conference Title

Gynecologic oncology


At the time of publication, Mary Lee was not yet affiliated with the University of Massachusetts Medical School.

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Link to Article in PubMed

PubMed ID