Obstet Gynecol Sci.  2017 Nov;60(6):602-607. 10.5468/ogs.2017.60.6.602.

Peptide YY producing strumal carcinoid tumor of the ovary in a postmenopausal woman: a rare cause of chronic constipation

• Noh HK
• Kwon BS
• Kim YH
• Lee NK
• Choi KU
• Suh DS
• Lee DH
• Kim KH

• KMID: 2418364
• DOI: http://doi.org/10.5468/ogs.2017.60.6.602

Abstract

Strumal carcinoid tumor of the ovary is a rare subtype of ovarian carcinoid tumors; it is characterized by an intimate mixture of thyroid and carcinoid tissues. We present a case of a 64-year-old woman who presented with the chief complaint of persistent, severe constipation for over 5 years; she was later found to have an ovarian strumal carcinoid tumor. Computed tomography showed a well-defined solid mass measuring 6.4 cm at the right adnexa. The patient underwent right salpingo-oophorectomy and was histopathologically diagnosed as having a strumal carcinoid tumor. Immunohistochemical examination showed immunoreactivity for peptide YY (PYY), which exerts an inhibitory effect on the peristaltic actions of the distal intestine. After surgery, the patient's constipation resolved rapidly, suggesting a correlation between PYY producing ovarian carcinoid tumor and constipation. This is the first case report of PYY producing primary strumal carcinoid tumor of the ovary associated with persistent, severe constipation from Korea.

Keyword

Strumal carcinoid tumor; Peptide YY; Constipation

MeSH Terms

Carcinoid Tumor*
Constipation*
Female
Humans
Intestines
Korea
Middle Aged
Ovary*
Peptide YY*
Thyroid Gland
Peptide YY

Figure

• 

  Fig. 1 (A) Contrast-enhanced computed tomography shows a well-defined hypervascular solid mass (arrow) in the right adnexa (uterus [U]). (B) On gross examination, the solid, pink-white tumor of the ovary measured 6.3×5.5×5.3 cm and had smooth outer surface and intact capsule. (C) Histopathologic examination revealing a carcinoid tumor associated with thyroid tissue (hematoxylin and eosin [H&E], ×100). (D) There are only a few glands lined by columnar epithelium with goblet cell (H&E, ×200).

• 

  Fig. 2 Immunohistochemical staining. (A) The tumor cells are diffusely positive for PAX8. (B) Carcinoid part of the tumor shows positive immunoreactivity for synaptophysin. (C) Follicles are surrounded by cells immunohistochemically positive for thyroglobulin. (D) Most of the cytoplasm of carcinoid tumor cells is positive for peptide YY.

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