Primary ovarian carcinoid tumors are uncommon neoplasms that typically arise in the context of a mature cystic teratoma. Pure primary ovarian carcinoid tumors (PPOCTs) are rare and present as a solid ovarian mass in which, by definition, elements of an associated teratoma or other neoplasm are absent. We report a case of a middle-aged woman who presented with abdominal distension. Computed tomography identified a 20 cm abdominopelvic mass. The patient underwent exploratory laparotomy, hysterectomy, and bilateral salpingo-oophorectomy. A large, solid, yellow-tan ovarian mass was resected and diagnosed as a PPOCT. Para-aortic lymph node metastases were identified. This case highlights the gross and microscopic findings characteristic of PPOCTs. In addition, the large number of differential considerations for an insular PPOCT at intraoperative evaluation are discussed.
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