Appendiceal adenocarcinoid with ovarian metastasis

The clinicopathologic features of an appendiceal adenocarcinoid that metastasized to the ovary and peritoneum after a 5-year disease-free interval are presented. A review of the literature reveals that appendiceal adenocarcinoid in women has a high frequency (32%) of ovarian metastasis. Among 18 cases with ovarian metastasis, the ovarian metastasis was diagnosed at initial presentation in 13 cases. In the remaining 5 cases the ovarian metastasis developed after disease-free intervals ranging from 6 months to 8 years. In most cases, the ovarian metastasis was the main clinical presentation of the patients. In 5 cases the ovary was the only site of metastasis clinically when metastasis was first diagnosed. There is no known effective treatment for disseminated adenocarcinoid. It is advisable that oophorectomy be included routinely in the initial surgical treatment of appendiceal adenocarcinoid, with the possible exception of the rare pure tubular variant.