Ahmad Rawaha, Loke Ian, Saifullah Fizza, Zafar Hafsa, Abbasi Saddam Hussain
Department of Cardiology, University Hospitals, Leicester, UK.
Department of Oncology/ Hematology, Northampton General Hospital, Northampton, UK.
Heart Views. 2024 Apr-Jun;25(2):106-109. doi: 10.4103/heartviews.heartviews_104_23. Epub 2024 Oct 10.
Primary ovarian carcinoid tumors, an extremely rare subset of ovarian malignancies (<0.1% of cases), typically manifest with abdominal pain and bloating. The occurrence of carcinoid heart disease (CHD) without classic carcinoid syndrome features is exceptionally uncommon. We report a 54-year-old female presenting with dyspnea and edema over months, lacking typical carcinoid syndrome signs. Initial assessments diagnosed heart failure, supported by elevated NT-Pro BNP, echocardiographic right ventricular dilation, and pulmonary/tricuspid valve regurgitation (normal left ventricular function). Right heart catheterization showed normal pulmonary/right ventricular pressures. Subsequent investigations (computed tomography thorax abdomen pelvis, 5-hydroxyindole acetic acid levels) strongly suggested carcinoid disease, confirmed by an octreotide scan revealing an octreotide-secreting ovarian carcinoid tumor. Surgical intervention included tricuspid and pulmonary valve repair, total abdominal hysterectomy, and bilateral salpingo-oophorectomy. Primary ovarian carcinoid tumors, though rare, may lead to unexpected complications like CHD. Timely diagnosis and intervention are pivotal for optimizing patient outcomes in such cases.
原发性卵巢类癌肿瘤是卵巢恶性肿瘤中极为罕见的一个亚型(占病例不到0.1%),通常表现为腹痛和腹胀。没有典型类癌综合征特征的类癌性心脏病(CHD)的发生极为罕见。我们报告一名54岁女性,数月来出现呼吸困难和水肿,缺乏典型的类癌综合征体征。初始评估诊断为心力衰竭,NT-Pro BNP升高、超声心动图显示右心室扩张以及肺/三尖瓣反流(左心室功能正常)均支持这一诊断。右心导管检查显示肺/右心室压力正常。随后的检查(胸部、腹部、盆腔计算机断层扫描以及5-羟色胺乙酸水平检测)强烈提示类癌病,奥曲肽扫描显示分泌奥曲肽的卵巢类癌肿瘤,从而确诊。手术干预包括三尖瓣和肺动脉瓣修复、全腹子宫切除术以及双侧输卵管卵巢切除术。原发性卵巢类癌肿瘤虽然罕见,但可能导致如CHD等意想不到的并发症。对于此类病例,及时诊断和干预对于优化患者预后至关重要。