Antimullerian hormone as a serum marker of granulosa cell tumors of the ovary: Comparative study with serum alpha-inhibin and estradiol

OBJECTIVE: Our purpose was to evaluate serum antimullerian hormone as a marker for granulosa cell tumors. STUDY DESIGN: Serum antimullerian hormone concentrations were determined in 16 patients with an adult-type granulosa cell tumor; in female patients with ovarian adenocarcinoma, benign ovarian cysts, or extraovarian cancers; and in normal premenopausal and postmenopausal women. Serum antimullerian hormone, alpha-inhibin, and estradiol levels were compared in 10 patients with a granulosa cell tumor during 6 to 47 months of follow-up. RESULTS: Serum antimullerian hormone was undetectable in normal postmenopausal women and was <5 mu g/L in premenopausal women. Normal serum levels were found in patients with ovarian cancers or cysts or with extraovarian cancers. Levels were between 6.8 and 117.9 mu g/L in eight of nine patients with a progressive granulosa cell tumor. In the remaining case antimullerian hormone, alpha-inhibin and estradiol concentrations were normal. Serum antimullerian hormone and alpha-inhibin levels became elevated at least 11 months before the recurrence was clinically detectable. During clinical remission serum antimullerian hormone, alpha-inhibin, and estradiol were normal in most cases. CONCLUSION: Serum antimullerian hormone is a sensitive, specific, reliable marker of adult-type granulosa cell tumors and is useful to evaluate the efficacy of treatment and to detect recurrences early.