Primary Carcinoid Tumour of Ovary Presenting with Severe Constipation - A Case Report

Abstract

Carcinoid is an uncommon tumour in ovary comprising 0.1 % of primary ovarian neoplasms and 1 % of all carcinoid tumours. It was first described by Stewart et al. in 1939 following which many case reports have come out.1They usually occur in the peri-menopausal age. Primary ovarian carcinoids are usually unilateral, but can show a cystic teratoma or mucinous neoplasm in the same or opposite ovary. Histological variants include insular, stromal, trabecular, and mucinous among which insular is the most common type, and around 30 % of them are associated with a carcinoid syndrome. Insular type is reported to be more common in western countries, whereas trabecular / stromal cases are more reported in Asian countries. Most carcinoids in ovary are diagnosed as an incidental radiological finding as an abdominal or pelvic mass or they may present with typical carcinoid syndrome - diarrhoea, flushing, bronchospasm, oedema, increase skin pigmentation, carcinoid heart disease. Another uncommon presentation is severe constipation associated with peptide YY production in the tumour. The clinical behaviour of carcinoid ranges from indolent unrecognisable to highly active metastatic secretory tumours. Carcinoid ovary being an uncommon tumour presenting in an uncommon site with varied presenting features, clinical confusion may lead to delayed diagnosis and management for patient. This case report aims to describe the clinicopathologic features of primary carcinoid ovary presenting in a female with severe constipation.