Neuroendocrine metastases to the ovaries are significantly associated with small bowel neuroendocrine tumors and carcinomatosis

Am J Surg. 2020 May;219(5):795-799. doi: 10.1016/j.amjsurg.2020.02.040. Epub 2020 Feb 25.

Abstract

Introduction: Neuroendocrine tumors (NETs) metastatic to the ovary are traditionally considered rare, but data are lacking. This study seeks to better characterize the prevalence and outcomes of patients with neuroendocrine ovarian metastases (NOM).

Methods: Women with well-differentiated lung and gastroenteropancreatic NETs 2007-2017 were identified by medical record query. Clinicopathologic data were reviewed among patients with and without NOM.

Results: Of 242 patients, 27 (11.2%) developed NOM. NOM developed in 24.8% of SBNET patients and 65.7% of patients with carcinomatosis and intact ovaries. 33.3% had associated small bowel obstructions; 11.1% had ureteral obstruction. NOM were not apparent on imaging in 29.6% nor visible intraoperatively in 8.3%. Five-year survival rate was 61.5%. Those who underwent oophorectomy had a lower rate of subsequent ureteral obstruction (p < 0.01).

Conclusions: NOM are more prevalent than previously reported and associated with significant morbidity. Empiric oophorectomy may be considered for SBNET patients and strongly advised in carcinomatosis.

Keywords: Carcinoid; Neuroendocrine tumors; Ovarian metastasis.

MeSH terms

  • Carcinoma / secondary*
  • Female
  • Humans
  • Intestinal Neoplasms / pathology*
  • Intestinal Obstruction / pathology
  • Intestine, Small
  • Lung Neoplasms / pathology*
  • Middle Aged
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / secondary*
  • Neuroendocrine Tumors / surgery
  • Ovarian Neoplasms / secondary*
  • Ovarian Neoplasms / surgery
  • Ovariectomy
  • Pancreatic Neoplasms / pathology*
  • Stomach Neoplasms / pathology*
  • Ureteral Obstruction / pathology

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor