Solid ovarian teratoma with carcinoid tumor and small cell neuroendocrine carcinoma in a 68-year-old patient: A case report

Abstract

We present the first reported case of a 68-year-old woman with an adrenal metastasis from a small cell carcinoma arising in an ovarian teratoma. The patient initially presented with an adrenal small cell carcinoma that was postulated to be a metastasis from a pulmonary primary given thyroid transcription factor 1 (TTF-1) positivity and an extensive smoking history. A Positron emission tomography (PET) scan failed to reveal a pulmonary lesion. However, PET avidity was seen in the adrenal, lung hilum and left adnexa. The ovary was resected and found to have a small cell carcinoma with identical immunohistochemistry as the adrenal tumor. Along with small cell carcinoma the teratoma also contained carcinoid both neuroendocrine components were intimately associated with benign pulmonary elements including bronchial cartilage. Ovarian teratomas showing foci of carcinoid or small cell carcinoma are rare and the presence of both within this teratoma makes this a very interesting case.

Keywords

• Teratoma
• Ovarian
• Carcinoid
• Small cell lung cancer (SCLC)
• Paraneoplastic endocrine syndrome
• Ovarian small cell carcinoma