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Bayani L, Shahbazkhani AH, Seifollahy A, Kashany L, Torabi S. Diagnostic challenges in primary ovarian carcinoid: Insights from radiological imaging-A case study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:809-812. [PMID: 38597286 DOI: 10.1002/jcu.23687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/30/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
Primary ovarian carcinoid (POC) is a very rare subset of ovarian tumors, presenting diagnostic challenges due to its inconclusive radiological imaging. In this case study, we present a 30-year-old nulliparous female with subfertility complaints and irregular menstrual cycles, who was initially misdiagnosed with an ovarian cyst. Subsequent comprehensive imaging, including Color Doppler, revealed high vascularity, and prompting suspicion of malignancy. Surgical resection and histopathological evaluation ultimately confirmed the presence of a rare Carcinoid tumor, insular type. This case emphasizes a multidisciplinary approach to the early detection and accurate diagnosis of POCs.
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Affiliation(s)
- Leila Bayani
- Department of Radiology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Akram Seifollahy
- Department of Pathology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Kashany
- Department of Infertility, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarah Torabi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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A rare case of ovarian carcinoid on mature cystic teratoma in a 36-year-old patient. Gynecol Oncol Rep 2022; 41:100999. [PMID: 35603130 PMCID: PMC9117527 DOI: 10.1016/j.gore.2022.100999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/30/2022] [Accepted: 05/07/2022] [Indexed: 12/03/2022] Open
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Ryzhkova D, Mitrofanova L, Tsoy U, Grineva E, Schlyakhto E. Dual-tracer PET/CT imaging to determine tumor heterogeneity in a patient with metastatic ACTH-secreting neuroendocrine neoplasm: A case report and literature review. Front Endocrinol (Lausanne) 2022; 13:958442. [PMID: 36133304 PMCID: PMC9483167 DOI: 10.3389/fendo.2022.958442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION We present a case of a patient with disseminated ACTH-secreting neuroendocrine neoplasm with biologic heterogeneity between a primary tumor and metastases. The diagnosis was obtained and multidisciplinary management was conducted with a positron emission tomography/computed tomography (PET/CT) scan with Gallium-68 [68Ga]-labeled dodecanetetraacetic acid-tyrosine-3-octreotate ([68Ga]-DOTA-TATE) and Fluor-18 [18F]-fluorodeoxyglucose ([18F]-FDG). CASE REPORT A PET/CT scan revealed a difference between [68Ga]-DOTA-TATE and [18F]-FDG uptake in primary tumor and several metastases. PET/CT showed high [18F]-FDG uptake and lack of [68Ga]-DOTA-TATE in the primary tumor, whereas both [68Ga]-DOTA-TATE and [18F]-FDG hyperaccumulation were identified in the majority of metastases. Despite positive [68Ga]-DOTA-TATE PET/CT, which is associated with high affinity with the somatostatin receptor 2 subtype, immunohistochemical examination revealed overexpression of the somatostatin receptor 5 subtype only. Perhaps, this explained the ineffectiveness of the treatment with "cold" somatostatin analogs. CONCLUSION This case had an aggressive clinical course, despite cytoreductive surgical treatment and somatostatin analog therapy. PET/CT imaging with two tracers is a molecular tool that demonstrates a biologic heterogeneity between a primary tumor and metastases and yields additional information that may influence the choice of the patient management strategy.
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Affiliation(s)
- Daria Ryzhkova
- Nuclear Medicine Department, Almazov National Medical Research Center, Saint Petersburg, Russia
- *Correspondence: Daria Ryzhkova,
| | - Lubov Mitrofanova
- Department of Pathomorphology, Almazov National Medical Research Center, Saint Petersburg, Russia
| | - Uliana Tsoy
- Department of Neuroendocrinological Tumors, Almazov National Medical Research Center, Saint Petersburg, Russia
| | - Elena Grineva
- Institution of Endocrinology, Almazov National Medical Research Center, Saint Petersburg, Russia
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Hu SXH, Ekladious A. Common presentation of an uncommon disease. Intern Med J 2021; 51:2153-2155. [PMID: 34939290 DOI: 10.1111/imj.15619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/18/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Sharon X H Hu
- Faculty of Medicine, St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Bega - South East Regional Hospital, Bega, NSW, Australia
| | - Adel Ekladious
- Bega - South East Regional Hospital, Bega, NSW, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
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5
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(Carcinoid heart disease in a patient with primary ovarian carcinoid). COR ET VASA 2021. [DOI: 10.33678/cor.2021.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Neuroendocrine Tumors: Clinical, Histological and Immunohistochemical Perspectives and Case Report-Mature Teratoma in a 16-Year-Old Girl. PATHOPHYSIOLOGY 2021; 28:373-386. [PMID: 35366281 PMCID: PMC8830444 DOI: 10.3390/pathophysiology28030025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022] Open
Abstract
A mature teratoma is a germinal neoplasm that differentiates from embryonic multipotent cells into three germ layers. There may also be glandular tissue. The literature describes a total of 658 cases of ovarian neuroendocrine neoplasms, mainly in women over 40 years of age. The authors, together with a systemic review, present a case of a 16-year-old girl diagnosed with and treated for a neuroendocrine tumor. Case description: A 16-year-old girl visited the Paediatric Gynaecology Outpatient Clinic because of abdominal pains that intensified during menstruation. Standard painkillers and diastolic drugs were ineffective. An ultrasound examination revealed a large tumor with a heterogeneous structure in her right ovary. A sparing operation was carried out. During laparotomy, the lesion was enucleated, leaving healthy tissue. Histopathological examination revealed the typical features of teratoma, as well as the coexistence of a G1 neuroendocrine tumor. Immunohistochemical examination (IHC) showed the presence of markers characteristic for this type of tumor. The patient requires constant monitoring in the Endocrinology and Oncological Gynaecology Clinic. Conclusion: Tissue of neuroendocrine neoplasm within a teratoma is rare in this age group of patients; thus, there are currently no standards for long-term follow-up. This case adds to the body of evidence and demonstrates a possible good prognosis with non-aggressive behavior in G1 neuroendocrine tumors and teratomas in young patients.
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Pulcini S, Berghian A, Edet-Sanson A, Carré F, Fontanilles M. Severe carcinoid syndrome revealing a primary ovarian carcinoid tumor. Bull Cancer 2021; 108:779-782. [PMID: 33867122 DOI: 10.1016/j.bulcan.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Serena Pulcini
- Cancer Centre Henri Becquerel, department of medical oncology, rue d'Amiens, 76000 Rouen, France
| | - Anca Berghian
- Cancer Centre Henri Becquerel, department of pathology, rue d'Amiens, 76000 Rouen, France
| | - Agathe Edet-Sanson
- Henri Becquerel Cancer Center and Rouen University Hospital, nuclear medicine department, Rouen, France; University of Rouen, faculty of medicine, QuantIF-LITIS (Équipe d'Accueil 4108), Rouen, France
| | - Fabienne Carré
- Jacques Monod Hospital, department of gynecology, Montivilliers, France
| | - Maxime Fontanilles
- Cancer Centre Henri Becquerel, department of medical oncology, rue d'Amiens, 76000 Rouen, France; Normandie université, Rouen University Hospital, UNIROUEN, IRON group, Normandy Centre for Genomic and Personalized Medicine, Inserm U1245, 76031 Rouen, France.
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Opalińska M, Sowa-Staszczak A, Olearska H, Ulatowska-Bialas M, Gilis-Januszewska A, Hubalewska-Dydejczyk A. Clinical Approach to Neuroendocrine Neoplasm Associated With Ovarian Teratoma. Front Endocrinol (Lausanne) 2021; 12:770266. [PMID: 34917031 PMCID: PMC8670552 DOI: 10.3389/fendo.2021.770266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Neuroendocrine neoplasms are a heterogeneous group of cancers that develop from enterochromaffin cells of the diffuse endocrine system, with an increase in incidents over the last years. Ovarian neuroendocrine tumors (NET) are rare neoplasms, comprising 0.1% of all ovarian neoplasms and less than 5% of all neuroendocrine tumors. They may arise alone (as monodermal, specialized teratoma - ovarian carcinoid) or as a part of other ovarian lesion: cystic mature or immature teratomas. Due to the rarity and limited amount of such cases reported in the literature, there is no consensus on diagnostic and therapeutic procedures in this group of patients. MATERIALS AND METHODS The group of 10 patients at the age of 19 to 77 years (mean 42.8 ± 17.9), diagnosed with unilateral NET within ovarian teratoma were analyzed. The histopathological type of tumor, progression free survival after surgical treatment and presence of hormonally active syndrome were assessed. RESULTS 70% (n=7) of patients was diagnosed with mature cystic teratomas containing NET component and 30% (n=3) with monodermal teratoma (strumal carcinoid). All cases of monodermal teratomas were found in women at premenopausal age. Determined Ki67 ranged from 2% to 9%. Ninety percent of lesions (n=9) stained positive for synaptophysin and chromogranin, while markers: CK20, CK7, TTF-1 and CDX2 were negative in all cases, which ruled out their metastatic nature. None of the patients presented with carcinoid syndrome. All followed-up patients remain progression-free, which confirms surgical intervention being a crucial and sufficient method of treatment. CONCLUSIONS The prognosis and clinical behavior of NETs associated with ovarian teratomas are good with long progression-free survival.
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Affiliation(s)
- Marta Opalińska
- Nuclear Medicine Unit, Department of Endocrinology Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Kraków, Poland
| | - Anna Sowa-Staszczak
- Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Anna Sowa-Staszczak,
| | - Helena Olearska
- Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
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Affiliation(s)
- Dominic Hayes
- Cardiology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
| | - Holly Morgan
- Cardiology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
| | - Nigel Brown
- Cardiology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK
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Mixed Large Cell Neuroendocrine Carcinoma of the Ovary: Report of a Rare Case. Case Rep Obstet Gynecol 2020; 2020:8896070. [PMID: 33294242 PMCID: PMC7714602 DOI: 10.1155/2020/8896070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/08/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
LCNC (large cell neuroendocrine carcinomas) of the ovary is a rare aggressive tumor entity of the genital tract. Its pathogenesis, origin, and prognosis have not been fully elucidated, since there are a limited number of cases reported in literature. We report a case of an 80-year-old patient, who presented with a growing abdominal mass, which turned out to be a mixed LCNC/epithelial neoplasm. Although this type of tumor is rare, the continuous development of pathologoanatomy and immunohistochemistry contributes to our better knowledge and comprehension of these neoplasms.
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Wadee R, Beavon I, Smith T, Mbodi L. Primary ovarian neuroendocrine tumour arising in a benign mature cystic teratoma: a case report and literature review. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2020. [DOI: 10.1080/20742835.2020.1832776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Reubina Wadee
- Department of Anatomical Pathology, University of the Witwatersrand/National Health Laboratory Service, Johannesburg, South Africa
| | - Ian Beavon
- Department of Histopathology, Lancet Laboratories, Johannesburg, South Africa
| | - Trudy Smith
- Department of Obstetrics and Gynaecology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Langanani Mbodi
- Department of Obstetrics and Gynaecology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
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Nasioudis D, Frey MK, Chapman-Davis E, Caputo TA, Holcomb K. Primary malignant ovarian carcinoid; management and outcomes. Gynecol Oncol 2020; 157:101-105. [PMID: 31959493 DOI: 10.1016/j.ygyno.2020.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/27/2019] [Accepted: 01/01/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the clinicopathological characteristics and survival of patients with malignant ovarian carcinoid tumor (OC). MATERIALS AND METHODS The National Cancer Database was accessed and patients diagnosed between 2004 and 2015 with a OC who did not have a personal history of a tumor at another site were selected. Overall survival (OS) was assessed for patients who had ≥1 month of follow-up. OS rates were estimated following generation of Kaplan-Meier curves and compared with the log-rank test. RESULTS A total of 588 patients with a median age of 51.5 years were identified. The majority were White (71.6%), had unilateral tumors (94.2%) with a median size of 3.8 cm that were confined to the ovary (88%). Patients with early stage disease (n = 431) had excellent OS compared to those with advanced stage (II-IV) disease (n = 51), p < 0.001; 5-yr OS rates were 95.4% and 53.1% respectively. For patients with stage I disease, there was no difference in OS between those who did (n = 211) and did not (n = 175) have hysterectomy, p = 0.92. For patients with advanced stage disease, administration of adjuvant chemotherapy was not associated with better survival, p = 0.093. CONCLUSIONS OCs are typically small, unilateral tumors confined to the ovary arising in perimenopausal patients. Survival outcomes are excellent for patients with early stage disease and unilateral salpingo-oophorectomy appears to be curative.
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Affiliation(s)
- Dimitrios Nasioudis
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA.
| | - Melissa K Frey
- Division of Gynecologic Oncology, Weill Cornell Medicine, New York, NY, USA
| | | | - Thomas A Caputo
- Division of Gynecologic Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Kevin Holcomb
- Division of Gynecologic Oncology, Weill Cornell Medicine, New York, NY, USA
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Primary ovarian mucinous carcinoid tumor: A case report and review of literature. Taiwan J Obstet Gynecol 2019; 58:570-573. [DOI: 10.1016/j.tjog.2019.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 11/20/2022] Open
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Chakraborty J, Chakraborty S, Roy A, Bhat S, Naga D, Chakraborty R, Mukherjee P. A Case of Primary Ovarian Insular Carcinoid Tumor Presenting with Carcinoid Syndrome. J Obstet Gynaecol India 2019; 69:71-75. [PMID: 30956498 DOI: 10.1007/s13224-018-1113-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 03/12/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jayanta Chakraborty
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Semanti Chakraborty
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Ankit Roy
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Saumen Bhat
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Dinabandhu Naga
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Rita Chakraborty
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
| | - Prabuddha Mukherjee
- Department of Endocrinology, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road, Kolkata, 700026 India
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Gupta N, Dougall P, Mahawar S. Primary ovarian carcinoid and dotanoc positron emission tomography-computed tomography scan. World J Nucl Med 2019; 18:69-70. [PMID: 30774552 PMCID: PMC6357718 DOI: 10.4103/wjnm.wjnm_14_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Primary ovarian carcinoids are very rare tumors, representing only <1% of all carcinoid tumors and <0.1% of all ovarian neoplasm. Here, we present a case report where DOTANOC positron emission tomography-computed tomography scan helped in diagnosis and management of rare entity.
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Affiliation(s)
- Nitin Gupta
- Department of Nuclear Medicine, Max Super Speciality Hospital, New Delhi, India
| | - Pankaj Dougall
- Department of Nuclear Medicine, Max Super Speciality Hospital, New Delhi, India
| | - Shruti Mahawar
- Department of Pathology, Max Super Speciality Hospital, New Delhi, India
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Antovska VS, Trajanova M, Krstevska I, Gosheva I, Chelebieva J, Prodanova I. Ovarian Strumal Carcinoid Tumour: Case Report. Open Access Maced J Med Sci 2018; 6:540-543. [PMID: 29610616 PMCID: PMC5874381 DOI: 10.3889/oamjms.2018.138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/01/2017] [Accepted: 02/20/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Ovarian strumal carcinoid is a germ cell tumour characterised by a mixture of thyroid tissue and carcinoid. Ovarian struma is a very rare occurrence with 0.3-1% incidence of all ovarian tumours and 3% of mature teratomas. Primary carcinoid ovarian tumours are still uncommon as a part of mature teratoma or mucinous cystadenoma. There are four major variants of a carcinoid tumour: insular, trabecular, strumal and mucinous. A strumal carcinoid is an unusual form of ovarian teratoma composed of an intimate admixture of thyroid/carcinoid tissues. CASE REPORT: This is a case report of a 59-year old woman with a 5-year clinical history of perimenopausal uterine bleeding and three explorative curettages. Gynaecological and ultrasound examinations revealed ovarian enlargement with a diameter of 50 mm with hypoechoic zones suspected of benign teratoma. The diagnostic test such as Ca-125, AFP, free-T4 and TSH was in normal range. A smooth, solid right ovarian 50 an mm-size tumour, as well as small amount of fluid in the Douglas pouch, was found during the total abdominal hysterectomy, bilateral salpingo-oophorectomy and staging biopsy. The histopathology revealed teratoma with strumal carcinoid tumour IA stage according to AJCC 2010 of the right ovary and negative cytopathology of the fluid from the Douglas pouch. On the postoperative 2-year control, the patient was tumour free, and Ca-125, free-T4 and TSH were in normal range. CONCLUSION: We would like to point out those specific diagnostic tools, such as ultrasound and Ca-125 have low specificity and sensitivity in detection of this rare ovarian malignancy.
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Affiliation(s)
- Vesna S Antovska
- Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia
| | - Milka Trajanova
- Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia
| | - Iskra Krstevska
- Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia
| | - Irena Gosheva
- Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia
| | - Jasmina Chelebieva
- Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia
| | - Irina Prodanova
- PHI Histolab, Diagnostic Laboratory for Cytology and Histopathology, Skopje, Republic of Macedonia
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