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Objective To report the clinicopathological features and treatment of 5 cases of primary ovarian strumal carcinoid and review the literature for improving the understanding to this disease. Methods The clinical data of 5 cases of primary ovarian strumal carcinoid collected in the Affiliated Jinhua Hospital, Zhejiang University School of Medicine (3 cases) and Dongyang People's Hospital (2 cases) from January 2009 to December 2020, and retrospectively analyzed by clinical features, microscopic appearance and immunohistochemical stains. The clinicopathological features and treatment methods of primary ovarian strumal carcinoid were summarized based on combined literature reports and retrieval of relevant literature databases of 28 patients. Results Case 1 and case 5 were primary ovarian strumal carcinoid, case 2 and case 4 were primary ovarian strumal carcinoid mixed with cystic teratoma. In addition, mucinous carcinoid was also seen in case 2. Case 3 was primary ovarian strumal carcinoid mixed with mucinous carcinoid. Immunohistochemical found the thyroid follicles of all the 5 cases were positive for thyroid markers, the carcinoid components were positive for neuroendocrine markers and somatostatin receptor 2 (SSTR2). Mucinous carcinoid of both case 2 and case 3 were positive for synaptophysin (Syn), chromogranin A (CgA) and caudal type homeobox transcription factor 2(CDX2). The Ki-67 proliferation index of all the 5 cases were less than 2%. In addition, the thyroid follicles of 5 cases also showed different levels of expression for neuroendocrine markers. During follow-up, 4 cases showed no recurrence or metastasis, and one case lost. A total of 28 cases of primary ovarian strumal carcinoid were searched in PubMed from 1971 to 2021 and SEER database from 1988 to 2011. The mean age of the patients was 51 and 46 years old. Except for one case of lymph node metastasis and one case of death, no tumor recurrence and metastasis were found during follow-up. Conclusions Primary ovarian strumal carcinoid is a kind of rare ovarian tumor. Some cases can be mixed with cystic teratoma and mucinous carcinoid. The patients often show no typical clinical symptoms. Missed diagnosis should be avoided during pathological sampling and diagnosis. Surgical methods that retain more organ functions are recommended in stage Ⅰ patients. The prognosis is generally excellent but long-term follow-up is needed to exclude recurrence and occult metastasis.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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