ECE2014 Poster Presentations Endocrine tumours and neoplasia (99 abstracts)
A rare ovarian carcinoma
Sabina Elena Oros 1 , Roxana Irina Rosca 1, , Diana Loreta Paun 1, , Anda Simona Dumitrascu 1 , Susana Vilma Vladoiu 1 , Andra Caragheorgheopol 1 , Ana Maria Stefanescu 1 , Silviu Voinea 3 , Madalina Gabriela Radu 3 & Dana Cristina Terzea 4
1National Institute of Endocrinology C.I.Parhon, Bucharest, Romania; 2University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; 3Institute of Oncology Prof.Dr. Alexandru Trestioreanu, Bucharest, Romania; 4National Institute of Research-Development in Pathology and Biomedical Science Victor Babes, Bucharest, Romania.
We present a rare association of ovarian carcinoid and virilization. A 65-year-old woman presented with a 9 years history of obesity, hypertension, dyslipidemia, stable angina, evaluated ambulatory for a postmenopausal virilization syndrome and flushes, with high testosterone and 17-hydroxyprogesterone (17OHP) levels without suppression during the 2×2 mg DXM test, normal gynecological evaluations with no tumor formation involving uterus, ovaries and adrenals at the pelvic ultrasound imaging and abdominal CT scan performed during the first referral.
The physical examination showed an obese patient with seborrhea and hirsutism. Blood analyses pointed to hyperuricemia, hypercholesterolemia, normal HbA1c and glycaemia, diabetes at OGTT, elevated estradiol and testosterone with CA125 in the normal range. Pelvic examination, ultrasound and CT showed a tumor developed in the left adnexal area tube and left ovary, left adrenal hyperplasia. Plasmatic and free urinary cortisol, ACTH were normal without responsiveness to the 1 mg DXM overnight test, normal DHEAS, 17OHP increased basal with lack of responsive to stimulation.
Our patient was referred to the Oncology Institute for a total hysterectomy with bilateral adnexectomy. Postoperatively, she returned with the diagnosis of insular ovarian carcinoid, confirmed at immunohistochemistry. After surgery, seborrhea and hirsutism improved. Blood analyses pointed to basal cortisol and ACTH in the normal range, positive response to 1 mg DXM overnight; serotonin, cromogranin A, neuron specific enolase and 5HIA, urinary MN and NMN in the normal range, 17OHP, total and free testosterone normalized with 17-KS slightly increased.
The CT scan screening did not find any secondary determination. In conclusion this case is peculiar due to a very rare association (only six published cases until now), flushes being present in the absence of secondary determination and the changed response of cortisol to DXM 1 mg test.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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