Our objective was to review the impact of adjuvant radiotherapy on recurrent granulosa cell tumor of the ovary.

Adult-type Granulosa cell tumors are uncommon neoplasms arising from the ovary's sex-cord stromal cells and account for 2-4% of all ovarian cancer. The hormonal features of AGCT explain the clinical manifestations for early diagnosis and recurrence prediction. Surgery is crucial for both initial and recurrent treatments, whereas adjuvant radiotherapy or chemotherapy therapy can induce clinical response and reasonable prevention of recurrence.

A 47-year-old Libyan woman had history of stage I AGCT of ovary diagnosed in 2012 after ovarian cystectomy, recure in 2016 with bilateral adnexal complex masses, fertility-sparing surgery was done followed by six cycles of chemotherapy then she starts hormonal therapy. In June 2021accedintal Para aortic lesion was discovered, but lost F/U. In January 2022, scans showed a right lateral vaginal vault lesion and other six lesions in the pelvis and abdomen, debulking of recurrent done.

Conventional radiotherapy to the whole pelvis by External beam was started using the linear accelerating machine, with a total radiotherapy dose of 45 grays (Gy) in 25 fractions for five weeks. No local recurrences, Nor lymph node, or systemic metastasis in serial CT scans of chest /abdomen /pelvis and MRI pelvis since January 2022 up to now.

Local radiotherapy could be considered as adjuvant therapy in recurrent GCTS due to the high recurrence rate, especially post-incomplete surgical excision.