Ovarian Carcinoid Tumor with Nodal Metastases: Case Report

E.V E.V Cafà,Roberto Angioli,Paolo Scollo

doi:10.4172/1948-5956.1000035

Abstract

Primary ovarian carcinoid tumors are very rare, they represent less than 0.1% of all ovarian cancers. The insular type is the most common, followed by the stromal, trabecular and mucinous types. A woman of 47 years old presented with lower abdominal pain, ultrasound evaluation revealed a voluminous pelvic mass on the right side. The patient underwent debulking surgery, it was diagnosed a carcinoid of the left ovary with prevalent trabecular and partly cribriform and insular pattern. Our patient had periaortic lymph node metastases, in this respect there is no evidence of involvement of lymph nodes for primary ovary, especially in the trabecular form, except for intestinal and pulmonary carcinoids. Therefore, this is the fi rst case of mixed primary ovarian carcinoid, particularly in predominantly trabecular form, with lymph node metastases, as described in the literature.

Highlights

Primary ovarian carcinoid tumors are very rare, they origin from neuroendocrine tissue and represent less than 0.1% of all ovarian tumors (De et al, 2004)
Ovarian carcinoids are characterized by neuroendocrine cells with round or cuboidal core and uniform granular chromatin and small nucleoli
Carcinoid syndrome is characterized by flushing, diarrhea, bronchospasm and hypertension, it is related to the secretion and release of metabolites by 5-hydroxytryptamine, kinins and prostaglandins by the tumor, it has been reported in 30% of insular carcinoid and in a few cases among trabecular and stromal forms

Summary

Introduction

Primary ovarian carcinoid tumors are very rare, they origin from neuroendocrine tissue and represent less than 0.1% of all ovarian tumors (De et al, 2004). There are different histological patterns: insular, trabecular, strumal and mucinous (Davis et al, 1996). The insular pattern is the most common (26-53%), followed by stromal (26-44%), trabecular (23-29%) and mucinous (1.5%) type (Dotto et al, 2008). The trabecular one is characterized by a clinical carcinoid syndrome and a favorable prognosis. Carcinoid of the ovary shows a single histological type, some cases of primary mixed carcinoid, characterized by two or more subtypes, have been reported (Mungen et al, 1997). Over 90% of cases are unilateral, distant metastases have been described only for subtypes with high proliferative activity, such as mucinous and insular (Kopf et al, 2005). We present a rare case of ovarian mixed, trabecular and insular, carcinoid with lymph node metastases

Case Presentation

Findings

Conclusions