Primary ovarian mixed strumal and mucinous carcinoid arising in an ovarian mature cystic teratoma

Abstract

A 39-year-old woman presented with low back pain lasting for several weeks. Abdominopelvic computed tomography showed an ovarian cystic mass with an enhancing solid portion, fat and internal calcification. A right salpingo-oophorectomy was performed. A 9.7 cm round multiseptated cystic mass showed pathology of mature cystic teratoma and contained a solid portion, measuring 4.2 cm, composed mainly of carcinoid cells arranged in a trabecular-insular configuration admixed with surrounding thyroid follicles containing colloid. Juxtaposed were several nests of columnar cells interspersed with goblet cells and extracellular mucin pools. In the cyst wall of the teratoma, the lining of pseudostratified columnar cells was occasionally mixed with goblet cells transforming to the carcinoid portion. Immunohistochemically, both mucinous and strumal carcinoids were positive for polyclonal carcinoembryonic antigen, caudal type homeobox 2, cytokeratin (CK)7, CK20, synaptophysin, CD56 and focally positive for chromogranin. Thyroid follicles were positive for thyroid transcription factor-1 and thyroglobulin. After gastrointestinal and respiratory tract evaluation, no evidence of primary tumor, including omentum, was observed. The mass was diagnosed as a mixed strumal and mucinous type carcinoid associated with a mature cystic teratoma.

Clinicopathological analysis of primary carcinoid tumour of the ovary arising in mature cystic teratomas

“…Most primary ovarian carcinoids coexist with teratomas and mucinous cystadenomas. 25 Approximately 85% of primary ovarian carcinoids are accompanied by components of teratomas. 25 Occasionally, mucinous cystadenomas or Brenner-like transitional cell nests can be identified.…”

“…25 Approximately 85% of primary ovarian carcinoids are accompanied by components of teratomas. 25 Occasionally, mucinous cystadenomas or Brenner-like transitional cell nests can be identified. 3 Only 10–15% of primary ovarian carcinoids are pure carcinoids.…”

Strumal Carcinoid Focus in Mature Cystic Teratoma in a Patient with Breast Cancer and Desire for Fertility Preservation

“…Immunohistochemistry is essential to complete the diagnosis. The carcinoid component is positive for synaptophysin and the thyroidal tissue expresses cytokeratin 19, TTF1 and thyroglobulin, as occurred in our case [14]. The main differential diagnosis must be made with the existence of a papillary thyroid carcinoma on the struma component of the teratoma [2].…”

Primary ovarian carcinoid tumor arising within a mature cystic teratoma in a 32-years-old patient.

“…• Primary carcinoid tumors arising in mature teratoma are tumors with low malignancy potential in most cases [4][5][6][7][8][9][10][11].…”