Metastatic carcinoid tumor of the ovary-A rare entity and role of CDX2 to distinguish pure primary carcinoid from metastatic carcinoid to the ovary

Abstract

Metastatic ovarian carcinoid is a very rare entity which is usually of primary gastrointestinal origin. Distinction is difficult between pure primary ovarian carcinoid from metastatic carcinoid tumor of ovary, but distinction is very much crucial because it has clinical and prognostic implications.We are reporting a case of a 55yr old female presented with abdominal pain. Ultrasonography revealed bilateral solid ovarian mass. Macroscopically both the ovaries were enlarged, solid with surface nodularity. Morphology showed tumor cells mostly in insular and acinar configuration, round to oval nucleus, stippled chromatin and granular eosinophilic cytoplasm. IHC for synaptophysin and chromograin were strong positive. CDX2 was done which showed strong nuclear positive in 80% of tumor cells. The tumor was diagnosed as a metastatic carcinoid tumor to the ovary and primary tumor in the small intestine. This case was reported because of its rarity and usefulness of CDX2 to distinguish pure primary carcinoid from metastatic carcinoid to ovary.