妊娠中に発見された成熟嚢胞性奇形腫に卵巣カルチノイドを合併した1例

抄録

  Carcinoid is a neuroendocrine tumor that often originates in the gastrointestinal tract. The frequency of primary ovarian carcinoid is about 1.3%. There is a debate whether it should be considered a germline borderline malignant tumor and be treated according to ovarian cancer treatment guidelines or considered a neuroendocrine tumor (NET) and be treated according to gastrointestinal carcinoid guidelines. It most commonly occurs after menopause and coexists with mature cystic teratoma in about 60-76% of the cases. Here, we report a case of primary ovarian carcinoid with mature cystic teratoma found during pregnancy. A 25-year-old woman experienced pain in her lower right abdomen at 29 weeks of gestation and was referred to our hospital. She had no obstetrical abnormalities, and ultrasonography and magnetic resonance imaging revealed a 9 cm mature cystic teratoma in the Douglas fossa. There was no suspicion of malignancy, and the pain subsided naturally, so we decided to perform the surgery after vaginal delivery. She delivered the baby on the 40th week of pregnancy. Laparoscopic surgery was performed 6 months after the delivery. Since cystic teratomas were found on both ovaries, bilateral cystectomy was performed. The postoperative pathology indicated a small focal lesion (ovarian carcinoid tumor) in the right mature cystic teratoma. A right salpingo-oophorectomy was planned. Mature cystic teratomas could coexist with ovarian carcinoids even in young women, and it is necessary to investigate treatment methods after analysis of relevant gynecological cases.