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Abstract
Introduction/Background Ovarian teratomas constitute the most common germ cell tumors (10–20%). Malignant transformation, rare at 1–3%, typically occurs in mature cystic teratomas. Moving to a different aspect of ovarian tumors, Neuroendocrine Tumors (NETs) represent a heterogeneous group, spanning aggressive small-cell cancers to well-differentiated carcinoid tumors. While uncommon in the gynecological tract, ovarian NETs represent only 0.5% of all carcinoid tumors and 0.1% of ovarian cancers.
Methodology We diagnosed two cases of ovarian neuroendocrine tumors at the University Hospital of Fes, Morocco, in December 2018 and January 2020. The evaluation encompassed an assessment of clinical radiological, histopathological findings and therapeutic aspects then the outcome.
Results In the first case, a perimenopausal patient presented with menorrhagia and abdominal pain. Diagnostic procedures, including ultrasonography, MRI, and hysteroscopy, revealed findings consistent with a mature right ovarian teratoma, and left ovarian endometrioma. The patient underwent hysterectomy with bilateral adnexectomy, and biopsy results indicated cancerized teratoma into a NETs of of digestive phenotype, classified as Stage IA according to FIGO. The first patient underwent chemotherapy with good progress and clinical stability.
In the second case, a postmenopausal patient exhibited flushing and diarrhea. Imaging, including ultrasound and CT scan, identified a solid cystic mass in the right ovary suggestive of serous cystadenocarcinoma. Surgical exploration revealed an ovarian neuroendocrine tumor of digestive phenotype, categorized as Stage IV according to FIGO. The patient, unfortunately, passed away before initiating chemotherapy.
Both cases showed positive immunological profiles for neuroendocrine markers. Digestive exploration, including abdominal CT, fibroscopy, and colonoscopy, yielded no anomalies.
Conclusion Ovarian NETs are typically treated with surgical resection, aiming for negative margins. Primary ovarian carcinoids are often FIGO Stage I, characterized by slow growth and infrequent metastasis, similar to Teratomas with malignant transformation. Given their rarity, additional literature reports may enhance our understanding and guidance for optimal management of these patients.
Disclosures The authors declare no conflicts of interest and report that no grants or financial support from any organization were received in connection with this study.
