peptide-yy and Ovarian-Neoplasms

Ovarian carcinoid tumors are uncommon and account for 1% of all carcinoid tumors. The insular type of ovarian carcinoid tumor is common in western countries; in contrast, the strumal and trabecular types seem to be common in Asian countries. Strumal and trabecular types are associated with peptide YY (PYY) production, which may cause constipation. Here, we report the case of a 70-yr-old Japanese woman with chronic constipation who was referred to Kumamoto University Hospital because of a right adnexal mass. Imaging tests suggested that the solid mass might be malignant; therefore, abdominal total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. A subsequent histopathologic examination confirmed an insular carcinoid tumor with a trabecular component in the right ovary. Both components were positive for PYY but not for serotonin. The patient complained of diarrhea instead of constipation soon after the surgery. Because PYY-positive insular carcinoid tumor in the ovary has not been previously reported, we reviewed 19 reported cases of patients with PYY-positive ovarian carcinoid tumors. The origins, common histologic types and symptoms caused by specific peptides secreted in ovarian carcinoid tumors differ between western and Asian countries.

Topics: Aged; Carcinoid Tumor; Chronic Disease; Constipation; Female; Humans; Ovarian Neoplasms; Ovariectomy; Ovary; Peptide YY

Primary carcinoid tumors are rare neoplasms of the ovary. Of the 4 histologic subtypes, ovarian carcinoid tumors with insular patterns produce carcinoid syndrome in approximately one third of cases, versus strumal and trabecular carcinoids which very rarely cause typical carcinoid syndrome. A unique presentation of ovarian carcinoid tumors with concurrent severe constipation has been reported, which is thought to represent a new carcinoid syndrome. The proposed mechanism is the production of peptide YY by the tumor, a gastrointestinal hormone responsible for decreasing gut motility. We report a case of a 34-yr-old white woman who presented with constipation and weight loss for 1 yr, and was found to have a unilateral ovarian strumal carcinoid, which produced peptide YY as demonstrated by immunohistochemistry. The 13 previous case reports of ovarian carcinoids with constipation are reviewed and the clinicopathologic features are discussed. This report and literature review further solidifies this entity as a new type of carcinoid syndrome.

Topics: Adult; Carcinoid Tumor; Comorbidity; Constipation; Female; Gastrointestinal Motility; Humans; Ovarian Neoplasms; Ovariectomy; Ovary; Peptide YY; Severity of Illness Index; Struma Ovarii; Syndrome; Treatment Outcome

Ovarian carcinoid is a rare tumor accounting for approximately 0.1% of all ovarian malignancies. We describe a case of peptide-YY-producing strumal carcinoid of the ovary associated with severe constipation. A 48-year-old woman was found to have a pelvic mass on ultrasonography when she visited her primary doctor for a health check-up. She was thus referred to our department. Magnetic resonance imaging revealed a solid right ovarian tumor 60 × 50 mm in size. The patient underwent a right adnexectomy and was histopathologically diagnosed as having strumal carcinoid of the ovary. On immunohistochemical examination, the tumor cells were positive for peptide YY. The patient's constipation resolved rapidly after surgery. Based on her clinical course, her constipation was considered to have been caused by the strumal carcinoid of the ovary. The clinical course of this case supports the previously recognized correlation between peptide-YY-producing ovarian carcinoid and constipation.

Topics: Carcinoid Tumor; Constipation; Female; Humans; Middle Aged; Neoplasm Proteins; Ovarian Neoplasms; Ovary; Peptide YY; Severity of Illness Index; Struma Ovarii

Primary ovarian carcinoid tumor is uncommon and represents less than 0.1% of ovarian malignancies. The strumal carcinoid may be complicated by carcinoid syndrome induced by peptide YY (PYY).. We describe a 45-year-old woman with a bilateral ovarian tumor diagnosed through periodical gynecological examination. She presented with severe constipation. Right ovarian cyst laparoscopically resected was diagnosed as a strumal carcinoid tumor; the left one was mature cystic teratoma. No metastatic findings were seen macroscopically on the ovarian surface and pelvic peritoneum. Constipation was drastically improved by resecting the tumor. The carcinoid tumor cells were positive for tumor-producing PYY by mRNA analysis.. It is important to be aware of this entity in the pathological diagnosis of ovarian tumors, in the presence of any clinical indicator of carcinoid tumor/syndrome, as it carries a markedly better prognosis and clinical outcome in comparison with most other malignant ovarian tumors.

Topics: Carcinoid Tumor; Female; Humans; Middle Aged; Ovarian Neoplasms; Peptide YY; RNA, Messenger; Struma Ovarii

Primary ovarian carcinoid tumors are rare. It has been reported that constipation was a presenting symptom in some patients with ovarian carcinoid. A case of strumal carcinoid of the ovary with contralateral clear cell adenocarcinoma of the ovary discovered with a complaint of constipation is described. Constipation was dramatically improved by resectioning the tumor. The tumor cells were positive for peptide YY (PYY) in the carcinoid component, but not in any other components. The present case could provide evidence of the correlation between constipation and PYY that has been reported elsewhere. Interestingly, the constipation caused by PYY also helped in discovering epithelial ovarian cancer.

Topics: Adenocarcinoma, Clear Cell; Carcinoid Tumor; Constipation; Female; Humans; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms; Ovary; Peptide YY

Peptide hormone receptors overexpressed in human malignant neoplasms are potential targets for diagnostic scintigraphy and radiotherapy. One such receptor is the neuropeptide Y (NPY) receptor, mediating primarily feeding behavior in the brain but shown recently to play a role in breast cancer. In this study, the presence of NPY receptors was evaluated in another group of gynecological tumors, namely ovarian tumors, using in vitro receptor autoradiography with (125)I-labeled peptide YY and receptor subtype selective analogs. Remarkably, all 10 investigated inhibin-expressing granulosa cell tumors, Leydig cell tumors, and Sertoli-Leydig cell tumors expressed NPY receptors. In contrast, receptors were found in only seven of 22 ovarian adenocarcinomas (32%). Pharmacological characterization of the expressed NPY receptor subtypes in the various tumors revealed the presence of Y1, Y2, or both. In addition, Y1 receptors were observed in intra- and peritumoral blood vessels as well. NPY receptors were not expressed in three ovarian adenomas, three borderline tumors, four fibromas and fibrothecomas, and one dysgerminoma. This is the first time that NPY receptors are described in human ovarian tissue. They may play a role in the pathogenesis and also in the pathophysiology of ovarian malignancies. Moreover, the high incidence and density of NPY receptors in sex cord-stromal tumors suggest that these receptors represent a new potential target for the diagnostic and therapeutic administration of NPY analogs in these tumors.

Topics: Adenocarcinoma; Adenoma; Autoradiography; Biomarkers, Tumor; Cell Line, Tumor; Female; Fluorescent Antibody Technique, Indirect; Humans; Iodine Radioisotopes; Neoplasms, Gonadal Tissue; Ovarian Neoplasms; Ovary; Peptide YY; Receptors, Neuropeptide Y

A case of a 58-year-old woman with ovarian carcinoid exhibiting double function is reported. She had suffered from constipation and hirsutism before surgery. Pathological examination revealed that many carcinoid tumor cells were immunohistochemically positive for peptide YY, which inhibits intestinal motility and many peripheral steroid cells. After surgery the patient recovered from constipation immediately. Although the serum level of testosterone also immediately decreased, hirsutism remained for about 2 years. These clinical manifestations are considered to be due to peptide hormone-producing tumor parenchymal cells and testosterone-producing functioning stromal cells. This is the first report of clinically manifested double-functioning ovarian carcinoid; one function is due to tumor cells themselves and another function is due to stromal cells.

Topics: Biomarkers, Tumor; Carcinoid Tumor; Constipation; Cytoplasmic Granules; Fallopian Tubes; Female; Hirsutism; Humans; Hysterectomy; Middle Aged; Neurosecretory Systems; Ovarian Neoplasms; Peptide YY; Testosterone; Treatment Outcome

Primary carcinoid tumor of the ovary is uncommon and represents less than 0.1% of ovarian malignancy. Recently, it was reported that the strumal carcinoid tumor may be complicated by severe constipation as one symptom of the carcinoid syndrome.. A 50-year-old nulliparous woman complained of persisting constipation and abdominal distention with pelvic mass, raising the possibility of ovarian tumor. The sugically resected tumor was diagnosed as strumal carcinoid tumor. Her long-lasting severe constipation completely disappeared after tumor removal but recurred with recurrent hepatic disease. The tumor cells were positive for PYY, a peptide hormone that has a strong inhibitory effect on intestinal motility, by immunohistochemical stain.. Our case provides the more convincing information to indicate that PYY protein, produced by ovarian tumor cells in the trabecular carcinoid component, may be associated with severe constipation.

Topics: Carcinoid Tumor; Constipation; Female; Humans; Middle Aged; Ovarian Neoplasms; Peptide YY

Functioning ovarian carcinoid tumors are well known to cause carcinoid syndrome. Recently, strumal and trabecular ovarian carcinoid tumors are reported to cause severe constipation possibly because of tumor-producing peptide YY (PYY). We studied a case of primary ovarian strumal carcinoid who had had severe constipation until the tumor was removed by surgical operation. Immunohistochemically, many tumor cells were strongly positive for PYY. By Northern blot and reverse transcription polymerase chain reaction analyses, PYY mRNA was expressed in a complete form as detected in normal human colon mucosa. From these findings, an ovarian strumal carcinoid is strongly suggested to express complete PYY mRNA and therefore complete PYY protein that results in severe constipation.

Topics: Blotting, Northern; Carcinoid Tumor; Constipation; Female; Humans; Immunohistochemistry; Middle Aged; Ovarian Neoplasms; Peptide YY; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Struma Ovarii

We report a patient with primary trabecular carcinoid of the ovary with severe constipation probably due to peptide YY production by the tumor. A 43-year-old female had complained of severe constipation for several months and was found to have a left ovarian tumor. The surgically resected tumor was diagnosed as trabecular carcinoid by light microscopic examination. The carcinoid tumor cells were intensely and uniformly stained by the Grimelius technique. Immunohistochemically, the tumor cells were strongly positive for peptide YY, which has a strong inhibitory action on intestinal motility. The patient has been free from constipation since the removal of the tumor. The present case supports previously reported findings that not typical carcinoid syndrome but rather severe constipation accompanies primary trabecular carcinoid of the ovary, and that peptide YY is presumably the cause of the constipation.

Topics: Adult; Carcinoid Tumor; Constipation; Female; Gastrointestinal Hormones; Humans; Ovarian Neoplasms; Peptide Biosynthesis; Peptide YY; Teratoma

Five patients with ovarian carcinoid who had severe constipation for a long period preoperatively showed marked reduction of this symptom postoperatively. Because this phenomenon was believed to be caused by some biologically active substance rather than a mechanical effect of the tumor, reactivity to 17 amine and peptide hormones was studied immunohistochemically in these patients. Numerous peptide YY (PYY)-positive cells were detected, with PYY-positive cells representing more than 50% of all carcinoid tumor cells in each patient. PYY, which has a pharmacologic inhibitory action on intestinal motility, was presumably the cause of the constipation in these patients.

Topics: Adult; Aged; Carcinoid Tumor; Constipation; Female; Gastrointestinal Motility; Humans; Immunohistochemistry; Middle Aged; Ovarian Neoplasms; Peptide Biosynthesis; Peptide YY

A case of ovarian carcinoid tumor of the trabecular type is presented. The small carcinoid tumor was found incidentally in a resected dermoid cyst. Histologically, the tumor was surrounded by a smooth muscle layer with focal stromal invasion. Non-carcinoid papillary mucosa and a few small glands, simulating the mucosa of the fallopian tube and remnant müllerian glands, respectively, were also present adjacent to the carcinoid tumor and enclosed by the same smooth muscle layer. The tumor cells revealed argyrophilia, and were positive for peptide tyrosine tyrosine (PYY) in the cytoplasm and for CEA in part of the luminal surface. This case was considered to be a rare ovarian carcinoid tumor arising from a dermoid cyst, without association of struma ovarii. PYY may be a potential marker for determining the histogenesis of ovarian carcinoid tumors.

Topics: Adult; Carcinoembryonic Antigen; Carcinoid Tumor; Dermoid Cyst; Female; Humans; Immunohistochemistry; Neoplasms, Multiple Primary; Ovarian Neoplasms; Peptide YY; Peptides