Primary ovarian carcinoids and neuro-endocrine tumours including struma ovarii

Ovarian carcinoids were first described in 1939 by Stewart et al. [1]. Most commonly ovarian carcinoids will be metastatic rather than primary [2-14, 41]. Of the primary ovarian carcinoids, the insular pattern is the most commonly seen. Carcinoids arising within or associated with an ovarian teratoma are also relatively common but vary with the pathological subtype. Today, it is preferable to adopt the new nomenclature adopted by WHO classification of Neuroendocrine Tumours (NETs) as deployed in other sites, although it is conceded, the old terminology will be used and remains familiar to many clinicians [15, 16]. As well as insular carcinoids, trabecular carcinoids (with trabecular or ribbon pattern) are described and strumal tumours capable of thyroid differentiation. Distinguishing advanced primary from metastatic carcinoid is not always easy but primary tumours tend to involve one ovary whereas metastatic disease usually involves both ovaries. It is suggested that primary insular tumours may commonly be associated with a mature teratoma both in the ipsilateral and sometimes in the contralateral ovary [4, 5, 7, 8, 14, 17]. Finally, goblet cell carcinoids are described, which most probably are adenocarcinomas, with some degree of neuroendocrine differentiation although collision tumours are occasionally described. The new WHO classification refers to these as mixed endocrine-exocrine cancers (MEEC), a term which is probably more useful [18]. This topic of mucinous tumours in the ovary is masterfully reviewed by Young [19, 20]. © 2011 Springer-Verlag Berlin Heidelberg.