Primary ovarian carcinoid

Abstract

Introduction: Carcinoid tumor is one of the most frequent neuroendocrine tumors, and the majority of which are usually observed in the lungs and gastrointestinal tract. The prevalence of ovarian carcinoids is merely 0.1% in ovarian neoplasms and 1% in carcinoid tumors. We described 2 rare cases in our hospital of primary ovarian carcinoid (POC), causing carcinoid syndrome (CS) of the diarrhea, constipation, and carcinoid heart disease. Besides, we also reviewed related literatures about its origin, variant, clinical manifestation, diagnosis methods, pathological features, treatment strategies and prognosis from 2009 to 2019. Patient concerns: Case 1 was a 61-year-old postmenopausal woman and presented with diarrhea, abdominal pain, enlargement, bloating and dizziness. Case 2 was a 49-year-old patient who complained of constipation, abdominal pain, bloating, and headache. Diagnosis: Both patients were diagnosed as primary ovarian carcinoid, insular type. Interventions: Total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), omentectomy, pelvic lymphadenectomy, and appendectomy without chemotherapy were performed in case 1. Cervix resection, right salpingo-oophorectomy, appendectomy, and pelvic lesion resection with chemotherapy was conducted in case 2. Outcomes: Both patients achieved satisfactory treatment effects. The follow-up period was 18 and 17 months in case 1 and case 2, respectively. Case 1 encountered carcinoid heart disease and received percutaneous transluminal coronary angioplasty (PTCA) postoperatively. Case 2 suffered multiple metastases postoperatively. However, after effective treatment, both patients were in good condition during follow-up duration. Conclusion: POC is an extraordinarily rare disease, and commonly with a satisfactory outcome. TAH+BSO with or without postoperative chemotherapy has been considered as an acceptable treatment strategy for POC patients.

Fortuitously detected primary ovarian carcinoid tumor: A case report

“…Primary ovarian carcinoids account for only 0.1% of all ovarian neoplasms. [1,4] They are the most common primary neuroendocrine tumors in the genital tract. [5] The cause of primary ovarian carcinoids is unclear, but it originates from germ cells.…”

“…[5,6] The age at diagnosis varies from 14 to 83 years, and peri- and postmenopausal women are the most affected. [1] Patients with primary ovarian carcinoids may present with no or nonspecific symptoms. Georgescu et al [7] analyzed 99 cases of primary ovarian carcinoids, described in 68 published articles and found that approximately 70% of the patients were symptomatic.…”

“…[5] For treatment of primary ovarian carcinoids, the patient's age, histological type, and stage should be considered. [1] Most primary ovarian carcinoids are often unilateral and confined within the ovary. Early-stage primary ovarian carcinoids are curable with surgery alone, but it is necessary to rule out gastrointestinal metastasis.…”

“…[3] Chemotherapy is considered for the treatment of advanced-stage tumors. [1] Stage I disease is associated with a favorable prognosis with a 10-year survival rate of almost 100%. By contrast, the advanced-stage disease is associated with a poor prognosis and a 5-year survival rate of only 33%.…”

“…Primary ovarian carcinoids are uncommon, and they account for 1% of all carcinoid tumors. [1] Carcinoid tumors, derived from the cells of the disseminated neuroendocrine system, are rare, slow-growing neuroendocrine neoplasms that display a relatively indolent disease course. They most often occur in the lungs, small intestine, and rectum.…”