Department of Pathology, The 309th Hospital of PLA, Beijing, China.
Arch Gynecol Obstet. 2010 Oct;282(4):407-11. doi: 10.1007/s00404-010-1600-4. Epub 2010 Jul 22.
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.
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.
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.
类癌肿瘤是弥漫性周围内分泌系统中罕见的肿瘤。卵巢类癌较为罕见，可以是原发性或转移性的。原发性卵巢类癌约占所有类癌肿瘤的 0.5-1.7%。
我们描述了一位 55 岁女性患者的病例。在常规检查中发现她的右侧卵巢有一个肿瘤。她没有明显的临床症状，但盆腔超声显示右侧卵巢叶有一个实性肿块，大小为 6.2x5.2x3.5cm。血清 AFP、CA199、CA125 和 CEA 水平均在正常范围内，血清 E2、FSH 和 Prog 激素水平也正常。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为两部分。肿瘤大小分别为 4.0x3.1x2.5cm 和 3.2x2.0x1.1cm，均为实性，呈黄色，表面光滑。肿块内未见畸胎瘤成分。多个切片显示肿瘤为完全上皮性肿瘤，由致密结缔组织环绕的小梁结构组成。肿瘤细胞胞浆颗粒丰富。银染色显示神经内分泌颗粒，网状纤维染色显示肿瘤细胞呈小梁状排列。免疫组织化学研究显示为神经内分泌起源，NSE、CgA 和 Syn 强阳性。其他标志物，如 a-inhibin 和 Calretinin，则为阴性。最终诊断为原发性卵巢小梁状类癌肿瘤。
原发性卵巢小梁状类癌肿瘤非常罕见。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来确认神经内分泌分化。
