Primary or secondary? Genotyping confirmation of an ovarian primary carcinoid tumor

Dotto J, Jorge Dotto, Mezzetti T, Thomas Mezzetti, Hui P, Pei Hui
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2008 · vol. 27(1) , pp. 33–6 · doi:10.1097/pgp.0b13e318053df4 · PMID:18156971
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DNA genotyping confirmed the germ cell origin of a large primary ovarian insular carcinoid tumor in a patient without extraovarian disease, distinguishing it from metastatic gastrointestinal carcinoids.

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This case report describes the diagnostic challenge of distinguishing a primary ovarian carcinoid tumor from a gastrointestinal metastasis in a 50-year-old woman presenting with a large 21.5-cm insular mass. Although the patient lacked extraovarian tumors, the absence of teratomatous components and presence of lymphovascular invasion necessitated further investigation to confirm the tumor's origin. The study utilized DNA genotyping to demonstrate germ cell origin, thereby confirming the lesion as a primary ovarian carcinoid rather than a secondary metastatic deposit. This paper is centrally about ovarian pathology but does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Ovarian primary carcinoid tumors of pure histological type can pose a significant diagnostic challenge in its separation from metastatic carcinoids from the gastrointestinal tract. Yet, their clinical management and prognosis are drastically different. At the molecular level, ovarian primary carcinoid tumors are thought to be of germ cell origin, frequently after the first meiotic division. We report a 21.5-cm ovarian insular carcinoid tumor in a 50-year-old woman who had no evidence of extraovarian tumor. The absence of teratomatous components and the presence of lymphovascular invasion prompted additional studies to rule out a metastatic tumor. The nature of this primary ovarian tumor was eventually confirmed by demonstration of its germ cell origin through DNA genotyping.
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Primary or Secondary? Genotyping Confirmation of an Ovarian Primary Carcinoid Tumor - Jorge Dotto - Thomas Mezzetti - Pei Hui Summary Ovarian primary carcinoid tumors of pure histological type can pose a significant diagnostic challenge in its separation from metastatic carcinoids from the gastrointestinal tract. Yet, their clinical management and prognosis are drastically different. At the molecular level, ovarian primary carcinoid tumors are thought to be of germ cell origin, frequently after the first meiotic division. We report a 21.5-cm ovarian insular carcinoid tumor in a 50-year-old woman who had no evidence of extraovarian tumor. The absence of teratomatous components and the presence of lymphovascular invasion prompted additional studies to rule out a metastatic tumor. The nature of this primary ovarian tumor was eventually confirmed by demonstration of its germ cell origin through DNA genotyping.

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MeSH descriptors

Carcinoid Tumor Carcinoid Tumor Ovarian Neoplasms Ovarian Neoplasms Carcinoid Tumor Carcinoid Tumor Diabetes Mellitus, Type 2 Diabetes Mellitus, Type 2 Female Genotype Humans Hypertension Hypertension Immunohistochemistry Lymphatic Metastasis Lymphatic Metastasis Middle Aged Obesity Obesity Ovarian Neoplasms

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