Role of diagnostic laparoscopy in patients with large cell neuroendocrine carcinoma of the ovary with cancerous peritonitis: case report and review of the literature

Abstract

Background Large cell neuroendocrine carcinoma is a very rare ovarian neoplasm that has a poor clinical outcome even in the early stage, and there is as yet no established treatment. Diagnostic laparoscopy has been used to determine the possibility of primary optimal cytoreductive surgery or neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. However, the role of diagnostic laparoscopy is still unclear in large cell neuroendocrine carcinoma due to its rarity. Case presentation A 31-year-old woman with abdominal distention was referred to our hospital. She was strongly suspected of having advanced ovarian cancer because of a huge pelvic mass, massive ascites, and their appearance on medical imaging. However, cytological examinations from ascitic fluid by abdominal paracentesis did not show any malignant cells. She underwent diagnostic laparoscopy to evaluate the possibility of primary optimal cytoreductive surgery, and only tissue sampling was performed for pathological diagnosis because of the countless disseminated lesions of various sizes in the intraperitoneal organs. The patient had no postoperative complications, leading to the early start of postoperative chemotherapy. Conclusions To date, there have been no systematic reviews that focused on determining the treatment strategy using laparoscopy. Diagnostic laparoscopy can be helpful to determine the optimal treatment, including primary debulking surgery, neoadjuvant chemotherapy, or best supportive care, assisting in decision-making particularly for patients with advanced large cell neuroendocrine carcinoma with carcinomatous peritonitis.

Pure large cell neuroendocrine carcinoma of the ovary with a somatic BRCA1 mutation: the first reported case and the review of the literature

“…Pure large cell neuroendocrine carcinoma (LCNEC) of the ovary is an exceptionally rare occurrence. Previous reports of LCNEC in the ovary have primarily been associated with other epithelial carcinomas or teratomas [2][3][4][5][6]. To date, including our case, only 26 cases of pure LCNEC of the ovary have been reported.…”

“…Conversely, the tumor cells were typically negative for PAX8, WT1, vimentin, estrogen receptor (ER), progesterone receptor (PR), and epithelial membrane antigen (EMA). The p53 protein exhibited a wild-type pattern, while the nuclear stains for SMARCB1/INI-1 and SMARCA4 were retained [1][2][3][4][5][6][7][8]. Based on the histopathological and immunohistochemical features, the nal diagnosis was established as pure LCNEC of the ovary.…”

“…Additionally, neuroendocrine neoplasia is very poorly understood [1]. Thus far, only 25 cases of pure primary ovarian large cell neuroendocrine carcinoma have been reported in English literature [1][2][3][4][5][6][7][8]. To the best of our knowledge, only one reported case had a con rmed BRAC2 germline mutation through molecular testing [2].…”

Ovarian Neuroendocrine Tumors: a Single-institution Experience

“…The case received neoadjuvant chemotherapy followed by internal debulking surgery (NACT-IDS). The role of diagnosis laparoscopy for patients with advanced-stage ovarian cancer was reported [19,20], and the mentioned studies will be help present a similar method for ONETs. Some patients diagnosed with O-NETs are of childbearing ages and willing to undergo fertility-sparing surgery.…”

Systematic retrospective analysis of 10 cases of neuroendocrine tumors of the ovary: diagnosis, treatment and follow-up

“…The patient received neoadjuvant chemotherapy followed by internal debulking surgery (NACT-IDS). The role of diagnosis laparoscopy for patients with advanced-stage ovarian cancer have been reported [19,20], and these studies will be helpful in offering a similar method for ONETs. Some patients diagnosed with ONETs are of childbearing age and are willing to undergo fertility-sparing surgery.…”