Granulosa cell tumor is the most common low-grade malignant tumor of the ovary with endocrine function, and is most common in women around 50 years of age. Because the tumor cells can secrete estrogen, precocious sexual development such as menstruation, breast development and genital development may occur in young age. Some patients may also have abdominal and pleural effusion. When the tumor is small in size, it appears substantial, mostly round or oval in progression, and the tumor gradually increases in size, and local hemorrhage and necrosis may manifest as a mixed mass. Due to the vasodilating effect of estrogen, the solid part of the tumor is significantly vasodilated, and the resistance index decreases, showing a high speed and low resistance type blood flow spectrum. The uterus also increases in size, endometrial thickening and uterine blood flow due to estrogen. Granulosa cell tumors are observed as solid or cystic masses with relatively clear borders, sometimes slightly lobulated, often with small foci of hemorrhagic necrosis in the cut surface, and with clear watery, gelatinous, or hemorrhagic fluid in the capsule of varying size; the cystic portion of a few tumors can be quite distinct or even almost completely cystic. Ovarian granulosa cell tumors are tumors with distinct clinical features. Patients with adnexal findings of masses accompanied by obvious symptoms of endocrine disruption caused by estrogen stimulation, but symptoms of endocrine disruption are not limited to granulosa cell tumors. Clinical staging is one of the most important factors in prognosis and is based on the extent of the disease detected by thorough exploratory surgery. In contrast, the 5-year survival rate for patients with stage III or higher is less than 20%. Relationship between pathological factors and prognosis Nuclear anisotropy and hyperdisintegrated phase are considered to be independent prognostic influences in ovarian granulosa cell tumors. In general, for early recurrent cases, the tumor has the characteristics of an aggressive tumor. In contrast, late recurrent cases have tumors with low-grade malignant potential. Although the size of the tumor or clinical evidence does not prove a difference between the two tumors, the proliferation pattern of late recurrent ovarian granulosa cell tumors is considered to be intermediate between that of tumor-free surviving ovarian granulosa cell tumors and early recurrent ovarian granulosa cell tumors. Nuclear heterogeneity and identical cell nuclear division are factors of postoperative recurrence or poor prognosis. Therefore, in determining the prognosis of the disease. Most authors now believe that it is difficult to distinguish ovarian granulosa cell tumors from other types of ovarian tumors before surgery to achieve an accurate diagnosis, so surgery is still the preferred treatment for granulosa cell tumors. However, the extent of surgery remains inconclusive. It is generally accepted that conservative surgery is necessary for young patients who need to preserve their reproductive function. That is, adnexal resection on one side, since the incidence of this type of tumor is about 3% in both ovaries simultaneously, and the extent of the first surgery affects the recurrence rate, according to Evans. Of the 108 patients studied by him, 80 were stage I patients, the rest were stage Ic or II or higher, and 1I patients were not staged. The results of their study showed that 17% of women underwent recurrence after total hysterectomy with bilateral adnexal resection. In contrast, the recurrence rate was 24% in patients who underwent other conservative procedures, i.e., unilateral adnexal resection. Adjuvant therapy after stage I surgery is still controversial; Smith et al. reported that adjuvant postoperative radiotherapy improved survival, and Savage suggested that radiotherapy could provide long-term remission in patients who could not tolerate surgical treatment. Most authors now believe that radiation therapy may be effective in reducing symptoms in recurrent disease or in patients who cannot undergo tumor cytoreductive surgery. Chemotherapy is now widely used in the treatment of granulosa cell tumors of the ovary. There are several reports of long-term remission after chemotherapy, but it is not clear whether it affects overall survival and whether recurrence occurs. Analysis of factors related to the time to recurrence One of the characteristics of granulosa cell tumors is distant recurrence. So far, the two cases with the longest recurrence time reported in the literature were both 37 years. The median time to recurrence was 4.0-7.3 years. Generally speaking, recent recurrences are often of high malignancy with significant nuclear anisotropy and nuclear schizophrenia. The average tumor size of recent recurrences was larger than that of tumor-free survivors. After multifactorial regression analysis, tumor stage was the only major factor associated with prognosis and recurrence.