Primary ovarian trabecular carcinoid tumor: a case report and literature review
Primary ovarian trabecular carcinoid tumor: a case report and literature review
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DOI：
10.1007/s00404-010-1600-4
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发表时间：
2010-10-01
影响因子：
2.6
通讯作者：
Yu, Qi
中科院分区：
文献类型：
--
作者：
Bai, Xuejuan;Li, Ning;Yu, Qi
类癌是一种少见的弥漫性外周内分泌系统肿瘤。卵巢类癌是罕见的，可以是原发性或移植性的。原发性卵巢类癌约占所有类癌tumors.Case报告的0.5-1.7%，我们描述的情况下，55岁的女性患者。在一次定期检查中发现她的右卵巢有一个肿瘤。她没有明显的临床症状，但盆腔超声显示位于卵巢右叶的一个6.2 x 5.2 x 3.5 cm的实性肿块。血清AFP、CA 199、CA 125和CEA水平均在正常范围内，血清E2、FSH和Prog激素水平也在正常范围内。患者接受了全子宫切除术和双侧输卵管卵巢切除术。妇科医生将右侧卵巢和肿瘤分成两部分。尺寸分别为4.0 x 3.1 x 2.5 cm和3.2 x 2.0 x 1.1 cm。肿瘤完全是实性的，呈淡黄色，表面光滑。肿块内未见畸胎瘤成分。多个切片显示肿瘤为全上皮性瘤变，具有被致密结缔组织包围的小梁结构。肿瘤细胞内颗粒细胞丰富。银染显示神经内分泌颗粒，网硬蛋白染色显示肿瘤细胞排列成小梁状结构。免疫组化结果显示，NSE、CgA和Syn均呈强阳性，为神经内分泌起源。其他标志物如α-腺苷酸和钙网膜蛋白也有阳性反应。最后诊断为原发性卵巢小梁类癌。结论原发性卵巢小梁类癌非常罕见。患者缺乏临床指标，最终诊断依赖于病理检查、特殊染色和免疫组化染色以证实神经内分泌分化。
Introduction Carcinoid tumors are uncommon neoplasms in the diffuse peripheral endocrine system. Ovarian carcinoids are rare and can be primary or transplanted. Primary ovarian carcinoids make up approximately 0.5-1.7% of all carcinoid tumors.Case report We describe the case of a 55-year-old female patient. A tumor in her right ovary was discovered during a regular examination. She had no significant clinical symptoms, but a pelvic ultrasound revealed a solid mass measuring 6.2 x 5.2 x 3.5 cm located in the right ovarian lobe. Serum AFP, CA199, CA125 and CEA levels were all within normal limits, as were serum E2, FSH and Prog hormone levels. The patient underwent a total hysterectomy and bilateral salpingo-oophorectomy. The right ovary and tumor were separated into two parts by the gynecologist. They were 4.0 x 3.1 x 2.5 cm and 3.2 x 2.0 x 1.1 cm in size, respectively. The tumor was totally solid and had a yellowish color and a smooth surface. There were no teratomatous components seen in the mass. Multiple sections showed that the tumor was a total epithelial neoplasia with a trabecular structure surrounded by dense connective tissue. The tumor cells had abundant granular cytoplasms. Silver staining showed neuroendocrine granules, and reticulin staining showed that tumor cells were arranged in a trabecular structure. The immunohistochemical study revealed a neuroendocrine origin with strong positivity for NSE, CgA and Syn. Other markers, such as a-inhibin and Calretinin, were negtive. Finally, the case was diagnosed as a primary ovarian trabecular carcinoid tumor.Conclusion Primary ovarian trabecular carcinoid tumors are very rare. The patients lack clinical indicators, and final diagnosis depends on pathological examination, special staining and inmmunohistochemistry staining to confirm the neuroendocrine differentiation.