Zhai Li-Rong, Zhang Xi-Wen, Yu Tong, Jiang Zhen-De, Huang Dong-Wei, Jia Yan, Cui Man-Hua
Department of gynecology and Obstetrics.
Department of Orthopaedics.
Medicine (Baltimore). 2020 Oct 2;99(40):e21109. doi: 10.1097/MD.0000000000021109.
Carcinoid tumor is one of the most frequent neuroendocrine tumors, and the majority of which are usually observed in the lungs and gastrointestinal tract. The prevalence of ovarian carcinoids is merely 0.1% in ovarian neoplasms and 1% in carcinoid tumors. We described 2 rare cases in our hospital of primary ovarian carcinoid (POC), causing carcinoid syndrome (CS) of the diarrhea, constipation, and carcinoid heart disease. Besides, we also reviewed related literatures about its origin, variant, clinical manifestation, diagnosis methods, pathological features, treatment strategies and prognosis from 2009 to 2019.
Case 1 was a 61-year-old postmenopausal woman and presented with diarrhea, abdominal pain, enlargement, bloating and dizziness. Case 2 was a 49-year-old patient who complained of constipation, abdominal pain, bloating, and headache.
Both patients were diagnosed as primary ovarian carcinoid, insular type.
Total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), omentectomy, pelvic lymphadenectomy, and appendectomy without chemotherapy were performed in case 1. Cervix resection, right salpingo-oophorectomy, appendectomy, and pelvic lesion resection with chemotherapy was conducted in case 2.
Both patients achieved satisfactory treatment effects. The follow-up period was 18 and 17 months in case 1 and case 2, respectively. Case 1 encountered carcinoid heart disease and received percutaneous transluminal coronary angioplasty (PTCA) postoperatively. Case 2 suffered multiple metastases postoperatively. However, after effective treatment, both patients were in good condition during follow-up duration.
POC is an extraordinarily rare disease, and commonly with a satisfactory outcome. TAH+BSO with or without postoperative chemotherapy has been considered as an acceptable treatment strategy for POC patients.
类癌瘤是最常见的神经内分泌肿瘤之一,其中大多数通常见于肺部和胃肠道。卵巢类癌在卵巢肿瘤中的患病率仅为0.1%,在类癌瘤中为1%。我们报道了我院2例罕见的原发性卵巢类癌(POC)病例,其引发了腹泻、便秘类癌综合征(CS)及类癌心脏病。此外,我们还回顾了2009年至2019年期间关于其起源、变异、临床表现、诊断方法、病理特征、治疗策略及预后的相关文献。
病例1是一名61岁的绝经后女性,表现为腹泻、腹痛、腹部增大、腹胀和头晕。病例2是一名49岁的患者,主诉便秘、腹痛、腹胀和头痛。
两名患者均被诊断为岛状型原发性卵巢类癌。
病例1行全腹子宫切除术(TAH)、双侧输卵管卵巢切除术(BSO)、大网膜切除术、盆腔淋巴结清扫术和阑尾切除术,未进行化疗。病例2行宫颈切除术、右侧输卵管卵巢切除术、阑尾切除术及盆腔病灶切除术,并进行了化疗。
两名患者均取得了满意的治疗效果。病例1和病例2的随访期分别为18个月和17个月。病例1术后出现类癌心脏病并接受了经皮腔内冠状动脉成形术(PTCA)。病例2术后发生多处转移。然而,经过有效治疗,两名患者在随访期间情况良好。
POC是一种极其罕见的疾病,通常预后良好。TAH+BSO联合或不联合术后化疗被认为是POC患者可接受的治疗策略。