220 Devadass et al., Int J Med Res Health Sci. 2014;3(1):220-223 International Journal of Medical Research & Health Sciences www.ijmrhs.com Volum e 3 Issue 1 (Jan- Ma r) Coden: IJMRHS Copyright @2013 ISSN: 2319-5886 Received: 9 th Dec 2013 Revised: 23 th Dec 2013 Accepted: 26 th Dec 2013 Case report SYNCHRONOUS OCCULT METASTASISING DUODENAL CARCINOID AND OVARIAN MUCINOUS CYSTADENOCARCINOMA–MULTIPLE PRIMARY MALIGNANCIES IN THE SAME PATIENT *Devadass Clement W 1 , Sridh ar Ho nnap pa 1 , Aa rat hi R Ra u 1 , Shara t Chand ra 2 1 Department of Pathology, M.S. Ramaiah Medical College, Bangalore, India 2 Department of Surgical Oncology, M.S. Ramaiah Medical College, Bangalore, India *Corresponding author email: [email protected]ABSTRACT Gastrointestinal carcinoid tumors are uncommon neuroendocrine tumours that may be associated with synchronous or metachronous primary tumours of other histological ty pe, most frequently colorectal adenocarcinomas. Primary ovarian mucinous adenocarcinomas have been repor ted to coincide with few other ovarian tumours and minority ofthese tumours may occu r in associatio n with Lynch syn drome. However associ ation of duod enal carci noid with ovari an mucinou s adenoca rcinoma is distinc tly unusua l and, to our knowl edge, has not been prev iously des cribed . We report a case of occult metastasising duod enal atypical carcinoid that was incidentally detected during surgical intervention performed for left ov arian mucinous cy stadenocarcinoma in a middle aged female. The carcinoid tumour was Stage IIIB with regional nodal metastasis and the ovarian tumour was Stage IA with low grade histology. Key words: Duodenal carcinoid, multiple primary malignancies, synchronous tumours. INTRODUCTION Synchronous and met ach ronous “Multiple primary malignancies” (MPM) are relatively rare with an overall occurrence rate between 0.73% to 11.7 %. 1-3 About 20-29% of small intestinal carcinoid tumours (CT’s) a re associ at ed wi th synchr onou s or metachronous primary non-carcinoid tumours, with colorectal adenocarcinomas being the commonest. 4, 5 Primary ovarian muci nous carc ino ma hav e been reported in conjunction with other ovarian tumors like teratoma, Brenner tumo ur, an d Ser toli- Leydig cell tumo ur and s ome o ccur in th e sett ing o f Lyn ch syndrome. 6 Howev er the simultaneo us occu rrenc e ofduodenal CT, which is rare, an d ovaria n mucinous cystadenocarcinoma, which according to recent studies const itutes on ly 3% all ovari an cancers, in the same pat ient is unu sua l. We pr esent a cas e of me tas tas isi ng duodenal CT that was incidentally detected during treatment of ovarian mucinous cystadenocarcinoma in middle aged female. CASE REPORT A 40 year old female presented with pain and m ass per abdomen of one year duration. She also complained ofprogressively increasing intermittent episodes ofrespiratory distress, diarrhoea, palpitations and weight loss. She denie d history of prolonged thera py with H2 bl oc kers an d famil y his to ry of mal ig na nci es . Abdominal examination revealed firm lobulated central pelvic mass. Abdomino-pelvic computed tomography revealed a large complex cystic ovarian mass [Figu re 1]. A comple te digest ive tract end oscop y, chest X-ray and gastri c and co lonic b iopsi es wer e normal. Lapar otomy s howed a left ovari an tumo ur, the frozen sections of which revealed mucinous DOI: 10.5958/ j.2319-5886.3 .1.048
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