http://www.alliedacademies.org/gynecology-reproductive-endocrinology/ Gynecol Reproduct Endocrinol -UK 2018 Volume 2 Issue 1 2 Case Report Introduction Mature cystic teratomas (MCT) or dermoid cyst represent 10- 20% of all ovarian neoplasm [1]. Primary ovarian carcinoids are rare, accounting for 0.3% of all carcinoid tumors and the majority of them are associated with MCT [2]. Malignant transformation of teratoma (TMT) is uncommon condition occurring in 1-3% of all mature cystic teratomas [3] and is very rare, with a very small number of published cases. We report a case of a 32-year-old woman diagnosed with primary carcinoid tumor of the left ovary arising in MCT. Case Report A 32-year-old patient with a casual diagnosis of left adnexal mass in a routine exam. Asymptomatic personal history: No allergies. Congenital cataracts: Raynaud's disease. Gynecological and obstetrical history: Menarche at age 12 years. Regular menstrual cycles. Two deliveries and one abortion. Contraceptive method: Copper diu. Negative PAP´s smears. Exploration without pathological findings: Uterus of normal size, mobile cervix. It is not possible to feel mass in bimanual touch. Vaginal ultrasonography demonstrated uterus of normal size and morphology. Diu normally inserted. Left cystic adnexal image of 60 × 40 mm, with fine echogenic dotting and a more refringent area in caudal pole. Doppler negative, douglas free, right ovary is not seen. It is not possible to clearly visualize the mass through abdominal ultrasound. Negative tumor markers: CA125: 10.2 u/ml. CA19.9: 16.5 u/ml. Negative for pregnancy test. Pelvic magnetic resonance imaging (MRI): Pelvic tumor of approximately 50 × 61 mm of suprauterine location with a thin hypointense capsule with well-defined borders and fat-like signal intensity, which impresses of mature cystic teratoma as the first diagnostic possibility. Diu normally inserted. Normal right ovary. No other findings of interest (Figure 1). Laparoscopy and left anexectomy was performed. Examination of the abdominal cavity is normal. The left ovarian tumor is compatible with teratoma. Right ovary, fallopian tubes and uterus are normal. No lymphadenopathy or other pelvic lesions are present. The sample is sent to the Patholoy Department. The intervention went without incident. Postoperative evolution was favorable (Figure 2). Macroscopically the surgical specimen was the left adnexa with fallopian tube 5 cm lenght and enlarged ovary, 5.5 × 3.5 cm. When slicing the specimen it was cystic with a small (1 cm) solid area. The cyst was filled with sebaceous material and hair. Histologically the tumor was integrated by poligonal cells with light and eosinophilic, cytoplasm with rounded nuclei with mild pleomorphism. No mitotic figures were identified. Those cells exhibited a trabecular and insular pattern (Figure 3). In other areas the tumor had the elements of a typical cystic teratoma, with structures resembling skin appendages, an queratin. The diagosis Mature cystic teratomas (MCT) or dermoid cyst represent 10-20% of all ovarian neoplasm. Primary ovarian carcinoids are rare, accounting for 0,3% of all carcinoid tumors. We report a case of a 32-years-old woman diagnosed with primary carcinoid tumor of the left ovary arising in MCT. Vaginal ultrasonography showed left cystic adnexal image of 60 × 40 mm, with fine echogenic dotting and a more refringent area in caudal pole. Doppler negative. Negative tumor markers. Pelvic MRI: Pelvic tumor of approximately 50 × 61 mm of suprauterine location with a thin hypointense capsule with well-defined borders and fat-like signal intensity, which impresses of mature cystic teratoma as the first diagnostic possibility.Laparoscopy and left anexectomy was performed. The histopathological study reports, mature cystic teratoma of 5 cm with a single focus (0.6 cm) of carcinoid tumor. It is difficult to make a diagnosis of primary ovarian carcinoid tumor arising within a mature cystic teratoma of the ovary preoperatively. A thorough histopathological study of the tumor is very important and the surgical treatment adapted according to the characteristics of the patient. Abstract Primary ovarian carcinoid tumor arising within a mature cystic teratoma in a 32-years-old patient. Manuel Dominguez Gonzalez * , Sofia Vazquez Navarrete, Raquel Jimenez Pena, Maria Carmen Escamez Leon Department of Gynecology and Obstetrics, Hospital La Linea, Avenida Menéndez Pelayo, 103 s/n, La Linea de la Concepción, Cadiz, Spain Accepted on January 22, 2018 Keywords: Carcinoid tumor, Dermoid cyst, Ovary, Teratoma.