Retreatment with aromatase inhibitor therapy in the management of granulosa cell tumor

•Over 90% of granulosa cell tumors have a FOXL2 mutation that contributes to aromatase upregulation.•Chemotherapy has demonstrated limited efficacy in the treatment of granulosa cell tumors.•A patient with recurrent granulosa cell tumor responded briefly to anastrazole treatment.•Retreatment with another aromatase inhibitor letrozole led to a durable response of 24 months.