This article is about an unusual case presentation of a stromal carcinoid in a 60-year-old nulliparous, post-menopausal woman. She presented to the physician with complaints of abdominal pain and loss of appetite. Moreover, she had symptoms of frequent urination and oedema in the left lower extremity.
Examination and Investigations
Doctors performed a physical examination which revealed epigastric tenderness and umbilical hernia along with a palpable mass. On further investigations, the ultrasound of the abdomen showed a large multiloculated cystic lesion presenting as a large pelvic mass. In addition, her MRI revealed that the solid internal component of the lesion was consistent with ovarian tumour. Her laboratory findings were positive for elevated cancer antigen 125 (CA125) and carcinoembryonic antigen (CEA). The histopathology results showed the presence of ectopic thyroid tissue admixed with neuroendocrine tumour.
Based on the histological findings and investigations, the doctors diagnosed it as stromal carcinoid.
What is stromal carcinoid?
It is a rare but most common form of monodermal teratoma present in the ovary and is a unilateral and benign tumour. Stromal carcinoid is an admixture of ectopic thyroid tissue and well-differentiated neuroendocrine tumour and accounts for 3% of all ovarian teratomas. They are most commonly present in pre-and post-menopausal women with a peak incidence in the fifth decade of life.
The treatment for stromal carcinoid is surgery. Therefore, the doctors performed a total abdominal hysterectomy, left salpingo-oophorectomy, omentectomy and umbilical hernia repair on the 60-year-old. This relieved her symptoms and she showed full recovery. Furthermore, the doctors discharged her with close follow up.
It is important to recognize these tumours so extensive surgery and staging can be avoided.