Ovarian carcinoid presenting with right heart failure

Area of Science:

• Cardiology
• Oncology
• Gynecology

Background:

• A 69-year-old woman presented with a pelvic mass and symptoms of right heart failure (RHF), including peripheral edema, breathlessness, and abdominal distension.
• Extensive investigations ruled out pulmonary disease or embolism as the cause of RHF.

Observation:

• Severe tricuspid incompetence was observed, suspected to be secondary to systemic effects of a carcinoid tumor.
• Positron emission tomography/CT scan and histopathology confirmed an ovarian carcinoid tumor as the origin.

Findings:

• The patient underwent tricuspid and pulmonary valve replacement due to deteriorating right heart function prior to pelvic mass surgery.
• Histopathology confirmed ovarian carcinoid tumor, linking carcinoid syndrome to severe cardiac valvular disease.

Implications:

• This case underscores the critical association between carcinoid syndrome and cardiac manifestations, particularly valvular heart disease.
• Early diagnosis and multidisciplinary management, including surgical intervention for both cardiac and oncologic conditions, are crucial for favorable outcomes in such complex cases.