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Ovarian Carcinoid : Clinical

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Clinical Presentation: Most patients with ovarian carcinoid are peri- or postmenopausal. The median age at diagnosis is 53 years. Many cases are asymptomatic and discovered incidentally. Others cause symptoms related to a pelvic mass or produce ascites. One-third of cases develop carcinoid syndrome, even in the absence of liver metastases. This occurs more commonly in older patients with large tumors (> 7 cm in size) and insular morphology.

The symptom complex of carcinoid syndrome includes diarrhea, vasomotor changes (flushing, erythema, cyanosis), dyspnea, hypertension, and carcinoid heart syndrome (characterized by tricuspid and/or pulmonary valve dysfunction and right-sided heart failure). Some patients develop severe constipation due to secretion of polypeptide YY by the tumor. Urine 5-HIAA levels are often elevated. Rare ovarian carcinoids occur in the setting of MEN type 1.

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