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Introduction/Background Ovarian carcinoids are uncommon tumors. Mucinous carcinoids, particularly if associated with atypical features, may have an aggressive behavior. Methodology A 34-year old woman underwent removal of a left ovarian mass which was diagnosed as Krukenberg’s tumor, probably of GI tract origin. An upper and lower GI endoscopy and biopsies of the mucosa of the stomach, were unremarkable. One year later the patient experienced a lower abdominal pain which required emergency diagnostic work up and treatment. The patient had an emergency exploratory laparatomy. Peritoneal washings were obtained and a greater omentectomy was performed. The duodenum was mobilized and palpated as well as the small bowel from the ligament of Treitz all the way to the ileocecal region. The head of the pancreas was checked with intraoperative ultrasound which showed no mass in that area. The stomach was palpated carefully and there was no evidence of any lesion. An incidental appendectomy was performed. Dissection of part of the remaining left fallopian tube, ovarian ligament and ovarian vessels was also performed. The pathologic examination showed the same type of lesion in the fallopian tube with lymphatic and vascular invasion. The patient‘s postoperative course was unremarkable. The diagnosis was transformed to goblet cell carcinoid of the ovary due to positive expression for neuroendocrine markers. Given her age and the desire to have family, the approach was more conservative. Nevertheless, in one year‘s time, the woman was re-admitted with ascites and underwent exploratory laparatomy with excision of the right ovary, which showed similar histologic features with the left ovary. Results The overall findings were of bilateral primary tumor of the goblet cell carcinoid type. Conclusion The primary neuroendocrine tumors of the ovary are very rare and their diagnosis needs a detailed work up and long follow up. This case adds to our knowledge for this rare tumor entity Disclosure Nothing to disclose. |
