Proliferative activity in primary ovarian carcinoid tumors

Abstract

The proliferative potential of six primary ovarian carcinoids with different clinical outcome and histogenetic origin was examined immunohistochemically. The results showed that two cases with extremely high level of proliferative activity were associated with metastatic spread. In the remaining tumors, the examined factor was found to be at low level comparable with excellent prognosis of typical carcinoids in other locations. The preliminary results showed a possibility of a prognosis prediction according to typing of the ovarian carcinoids into two categories, i.e., tumors of low and intermediate malignancy. Topoisomerase II-alpha and Ki-67 are suitable markers giving valuable information about this phenomenon.

Primary Ovarian Carcinoid: Extensive Clinical Experience With an Underrecognized Uncommon Entity

“…6 Patient care should be in a specialist cardiothoracic unit experienced in managing patients with carcinoid heart disease. Newer more minimally invasive techniques may allow safe, aortic and pulmonary valvular replacement (patent foramen ovale closure), but valvular surgical interventions will depend on the patient factors and disease status.…”

“…In addition, the Ki-67 index of proliferation, used in other NETs, historically was often not reported, although it is now recognized to be of significant clinical importance. 6 As ovarian carcinoids drain directly into the systemic venous circulation, they may present with a carcinoid syndrome independent of the presence of liver metastases and thus may present relatively early; indeed, it has been suggested that there is a correlation between the size of the tumor and the presence of a clinically detectable carcinoid syndrome, with the critical cutoff being 10 cm. 7 The diagnosis of a primary ovarian NET needs to be considered whenever a unilateral ovarian tumor is found; careful evaluation of the intestinal tract and contralateral ovary with an experienced histopathologist is indicated before the definitive diagnosis is made.…”

Primary strumal carcinoid tumor of the ovary with multiple bone and breast metastases

“…The proliferative activity of primary ovarian carcinoid tumors could be a prognostic factor. In a study of ovarian carcinoid tumors, metastatic spread occurred in two cases with extremely high proliferative activity, but not in another four cases with low proliferative activity 13 . The understanding of these tumors in the respiratory system is more complete and at this site the tumors are classified into two types, typical and atypical carcinoid tumors, which are characterized by low and intermediate malignancy, respectively, and different prognoses 10,14 .…”

“…In the present case, immunohistochemical staining was highly positive for topoisomerase IIα and Ki‐67. Thus, topoisomerase IIα and Ki‐67 may be suitable markers providing valuable information regarding the prognosis for ovarian carcinoid 13 …”