Abstract
Adult-type ovarian granulosa cell tumors are rare low-grade malignancies characterized by late recurrence and atypical clinical manifestations. This study reports two cases of recurrent adult-type ovarian granulosa cell tumor with distinct timelines and anatomical sites, including one case with two postoperative recurrences. We analyze their imaging features, surgical management, histopathology, postoperative follow-up, and review relevant literature. These cases highlight the importance of long-term follow-up and raise awareness of rare recurrence sites, emphasizing the diagnostic value of imaging and the need for individualized surveillance strategies in adult-type ovarian granulosa cell tumor patients.