Background: Late recurrence can be extensive with initial, clinically undetectable, microscopic granulosa cell tumor of the ovary.
Case: We describe an 83-year-old patient who presented with extensive recurrent granulosa cell tumor of the ovary 6 years after undergoing abdominal hysterectomy and bilateral salpingo-oophorectomy for atypical endometrial hyperplasia with an incidental microscopic finding of ovarian granulosa cell tumor.
Conclusion: Patients must be monitored closely after a diagnosis of ovarian granulosa cell tumor, even if the tumor is occult.