Strumal carcinoid of the ovary - report of two cases and review of literature.

OBJECTIVE

Strumal carcinoid (SC) is a rare ovarian germ-cell tumour, which is characterized by a mixture of thyroid tissue and carcinoid. It can be presented as a monodermal teratoma or as a part of mature cystic teratoma (dermoid cyst).

DESIGN

Case report.

SETTING

Department of pathology, St. Elisabeth Cancer Institute, Bratislava.

METHODS AND RESULTS

Hereby the authors describe two cases of this rare tumour in clinically asymptomatic women, 46- and 52-year-old, whom tumours were diagnosed at preventive gynaecological examination. The tumours considered of solid - cystic features, measured 65×45×40 mm and 75×45×40 mm and both contained parts of SC represented by tougher yellowish gelatinous areas. In both cases, SC was a part of the mature cystic teratoma (dermoid cyst), with predominated content. Histologically, both SC had a characteristic composition of intimate mixture of mature thyroid tissue and carcinoid. Immunohistochemically, the thyroid tissue stained positively with cytokeratin7, thyroglobulin and thyroid transcription factor-1, and the carcinoid component exhibited expression of synaptophysin and chromogranin A (only in one case). Tumour cells of both components of SC were negative for calcitonin and carcinoembryonic antigen. Both tumours showed low proliferation activity expressed by Ki-67 (up to 2%). Tumours were diagnosed in stage IA, and up to now are patients without any complications associated with tumours, free of relapse for 3 years and 6 months, respectively.

CONCLUSION

SC represents an interesting form of primary ovarian carcinoid, which is usually asymptomatic and when confined to ovary, mostly has benign behaviour and can be treated by simple one-sided or bilateral adnexectomy. Keywords ovary, germ cell tumours, strumal carcinoid, immunohistochemistry.