Primary ovarian carcinoid arising in associated mature cystic teratoma.

BACKGROUND: Primary ovarian carcinoid is a very rare ovarian low-grade neuroendocrine tumor, accounting for about 0.1% of all ovarian neoplasms. CASE PRESENTATION: We reported a case of primary ovarian carcinoid arising from a mature cystic teratoma in a 50-year-old woman. Intraoperative frozen section of left ovarian mass was assessed and a malignant epithelial tumor was considered. Morphologically, the main tumor was composed of cells forming trabeculae, and mature cystic teratoma was observed adjacent to the main part. Immunohistochemistry revealed that the trabecular cells were diffuse positive for pan Cytokeratin, CD56 and synaptophysin with low Ki-67 index (about 1%). CONCLUSIONS: Careful morphological observation combined with appropriate accessory examination are essential for the diagnosis of primary ovarian carcinoid arising from mature cystic teratoma. In addition, the classification criteria of the primary ovarian neuroendocrine tumor are discussed.

Metastatic Bilateral Strumal Carcinoid: A Case Report and Review of the Literature.

Primary ovarian carcinoids are very rare tumors that belong to the germ cell family of ovarian malignancies. They account for less than 1% of all carcinoid tumors and for less than 0.1% of all ovarian neoplasms. Recurrences are even rarer, with only few cases reported in the literature. Strumal carcinoid has recently been recognized as an extremely rare distinct entity. We report on a patient with bilateral mature cystic teratoma with millimetric foci of ovarian strumal carcinoid who developed lymph node para aortic metastasis after 30 years from primary diagnosis. Our case is thus far the second report of a metastatic strumal carcinoid and the first one in which strumal carcinoid occurred bilaterally and was also metastatic.

Mature cystic teratoma complicated with primary ovarian carcinoid: A report of 3 cases and literature review / 吉林大学学报(医学版)

Objective: To discuss the clinical characteristics, diagnosis, treatment experience and prognosis of mature cystic teratoma complicated with primary ovarian carcinoid, and to summarize its general charateriseics and to enhance the knowledge of clinician. Methods: Three female patients presented unilateral ovarian tumor in physical examination and were admitted to hospital. The tumor markers of three patients were normal. The preoperative diagnosis was ovarian tumor. Unilateral salpingo-oophorectomy was conducted in two patients. The resection of ovarian tumor was conducted in one patient. Results: The three patients underwent operation successfully. The postoperative pathological diagnosis was mature cystic teratoma complicated with primary ovarian carcinoid. The patients recovered well, who accepted 15-month follow-up with normal life and stable condition, and had no recurrence and metastasis. Conclusion: Mature cystic teratoma complicated with primary ovarian carcinoid is easy to be misdiagnosed before operation. Salpingo-oophorectomy is commonly used as the treatment method of mature cystic teratoma complicated with primary ovarian carcinoid and it can result in good effectiveness and better prognosis.

Mature cystic teratoma complicated with primary ovarian carcinoid:A report of 3 cases and literature review / 吉林大学学报(医学版)

Objective:To discuss the clinical characteristics,diagnosis,treatment experience and prognosis of mature cystic teratoma complicated with primary ovarian carcinoid,and to summarize its general charateriseics and to enhance the knowledge of clinician.Methods:Three female patients presented unilateral ovarian tumor in physical examination and were admitted to hospital.The tumor markers of three patients were normal. The preoperative diagnosis was ovarian tumor.Unilateral salpingo-oophorectomy was conducted in two patients.The resection of ovarian tumor was conducted in one patient.Results:The three patients underwent operation successfully.The postoperative pathological diagnosis was mature cystic teratoma complicated with primary ovarian carcinoid.The patients recovered well,who accepted 15-month follow-up with normal life and stable condition,and had no recurrence and metastasis.Conclusion:Mature cystic teratoma complicated with primary ovarian carcinoid is easy to be misdiagnosed before operation.Salpingo-oophorectomy is commonly used as the treatment method of mature cystic teratoma complicated with primary ovarian carcinoid and it can result in good effectiveness and better prognosis.

Primary ovarian neuroendocrine tumor arising in association with a mature cystic teratoma: A case report.

Primary ovarian carcinoid tumors are exceptionally rare entities accounting for approximately 0.1% of all ovarian neoplasms. This report describes a primary ovarian neuroendocrine tumor arising in association with a mature cystic teratoma in a 65 year-old woman. Macroscopically, the unilateral adnexal tumor was composed of cystic, solid and mucinous elements which resolved into a dual component lesion histologically. The majority of the tumor displayed an organoid architecture with mild to moderate pleomorphism and no discernible mitotic activity, while approximately 10% consisted of sheets and groups of cells with highly pleomorphic nuclei, necrosis and occasional mitoses. Features of a mature cystic teratoma were seen very focally. Immunohistochemistry revealed strong, diffuse positivity for CD56 and synaptophysin. Chromogranin immunonegativity was noted and there was an absence of nuclear ß-catenin accumulation. Ki-67 index was 10-12%. Although there is no established diagnostic framework for primary ovarian carcinoid tumors, this case was diagnosed as a well-differentiated neuroendocrine tumor, Grade 2 (intermediate grade), arising in association with a mature cystic teratoma/dermoid cyst. This case highlights the need to develop ovarian diagnostic criteria in this area.

Primary insular carcinoid of the ovary with carcinoid heart disease: Unfavourable outcome of a case.

INTRODUCTION: Primary ovarian carcinoid is a very rare disease. Carcinoid heart disease occurs in about one-third of patients with carcinoid syndrome. Cardiac involvement may be a cause of death in this syndrome. PRESENTATION OF CASE: We presents the unfavourable outcome of a 78-year-old woman admitted to the hospital complaining severe dyspnea and peripheral oedemas. Because of the presence of a large pericardial effusion with compression of cardiac chambers, an evacuative pericardiocentesis was performed. Computed tomography showed a solid pelvic mass with ascites. She underwent a complete surgical staging. Histological findings revealed an insular carcinoid stage IA. Three weeks later she was readmitted to the hospital and echocardiography demonstrated a right tricuspid valvular involvement with stenosis and severe regurgitation with a 2 cm masses in the posterior mitral leaflet. Hemoculture was positive for Staphylococcus aureus. Patient was not suitable for surgical intervention and decease due to sepsis and because secondary complications of the mitral endocarditis. DISCUSSION: High level of 5-HIAA has a rule in the development and progression of the carcinoid heart syndrome and could lead the right tricuspid valvular involvement. In the case we presented the bacterial endocarditis worsened the cardiac functions and the clinical conditions before she deceased. CONCLUSION: Ovarian primary carcinoid tumors are very rare tumors that require appropriate preoperative diagnosis. Even if survival is usually excellent, when carcinoid syndrome with heart involvement is present, a high level of attention is mandatory to prevent and limit damage caused by the vasoactive amine secreted by the tumor.