Primary adenocarcinoid tumor of the ovary arising in mature cystic teratoma. A case report.

Primary carcinoid tumors of the ovary are rare, forming 0.3 % of all carcinoid tumors and less than 0.1 % of ovarian malignancies. We present a case of a 47-year-old woman with abnormal vaginal bleeding and abdominal discomfort. Pelvic ultrasonography revealed a right-sided, 4 cm solid ovarian mass. At laparoscopy, a smooth surfaced, firm and mobile right adnexal mass with solid and cystic portions was detected and the tumor was excised. Pathologic and immunohistochemical examination revealed carcinoid tumor. After the evaluation of gastrointestinal and respiratory systems by imaging and endoscopic studies, no evidence of tumor tissue or metastases were found. Based on this finding, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and appendectomy were performed and pelvic-paraaortic lymph nodes were also removed. All histological findings were similar to the features of mature cystic teratoma and carcinoid tumor. Examination of the resected lymphatic, omental and appendiceal tissue indicated no tumoral invasion. Thus, the diagnosis was primary ovarian carcinoid arising from a mature cystic teratoma. This case, in the setting of a normal appendix and negative workup for an extraovarian origin, is one of a primary ovarian adenocarcinoid tumor. The primary carcinoid tumor should be differentiated from a metastatic carcinoid inside the ovary, which is always bilateral. It is important to be aware of this unusual entity in diagnoses of ovarian tumors, even in the absence of any clinical symptoms of carcinoid syndrome.

The use of a prostacyclin analog, iloprost, as an adjunct to uterus preservation with histidine-tryptophan-ketoglutarate solution.

INTRODUCTION: Although assisted reproductive techniques have made most causes of both male and female infertility treatable, uterine factor infertility is not able to therapy. Therefore, transplantation of the uterus has been suggested as a future possible cure. Organ preservation solutions seek to reduce reperfusion injury. Since iloprost is an antioxidant with cytoprotective properties, we investigated its potential positive effects in histidine-tryptophan-ketoglutarate (HTK) solution after 4 or 24 h cold storage period of the rat uterus. METHODS: We divided 24 female Wistar-albino rats into four groups: Group 1 had the uterus tissue stored in HTK solution at 4 °C for 4h. Group 2, the tissue was stored in HTK solution combined with iloprost (10(-8) M) for 4h at 4 °C. The same procedures were repeated for 24 h for Groups 3 and 4 respectively. Tissue levels of malondialdehyde (MDA) and nitric oxide (NO), as indicators of oxidative stress were determined with histopathological evaluations. RESULTS: MDA and NO levels were compared between the group 1 vs 3; and 2 vs 4. No significant difference was observed between the groups. Cold storage for 24 h produced alterations in histological appearances that were mitigated by the addition of iloprost to HTK solution. CONCLUSION: In conclusion, addition of iloprost to HTK solution reversed the histological alterations after 24h-cold storage of the rat uterus.