ovarian large-cell neuroendocrine carcinoma

Ovarian Large-Cell Neuroendocrine Carcinoma (LCNEC): A Rare and Aggressive Tumor

Ovarian large-cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive type of cancer that affects the ovaries. It is characterized by large pleiomorphic cells with large round or oval nuclei, presence of mitoses, and staining for neuroendocrine markers [1][6].

Key Features:

• Large cell size
• Pleiomorphic cells (cells of varying shapes)
• Large round or oval nuclei
• Presence of mitoses (cell division)
• Staining for neuroendocrine markers

Clinical Behavior:

Ovarian LCNEC is a highly aggressive tumor with a tendency to present at advanced stages and cause death after a short postoperative duration [3][8]. It is often associated with poor outcome, even at an early stage [8].

Association with Other Tumors:

Ovarian LCNEC is frequently associated with surface epithelial and germ cell neoplasm components [10][15]. This association suggests that the tumor may arise from a common precursor cell or share similar genetic alterations.

Diagnostic Challenges:

Establishing a definite diagnosis of ovarian LCNEC requires histopathologic examination with immunohistochemical demonstration of neuroendocrine differentiation in the tumor cells [11].

Prognosis:

The prognosis for ovarian LCNEC is generally poor, even at an early stage. The aggressive behavior and rarity of the disease make it challenging to develop effective treatment strategies.

References:

[1] IA Voutsadakis · 2014 [3] EY Ki · 2014 [6] Ovarian large-cell neuroendocrine carcinoma is characterized by large pleiomorphic cells with large round or oval nuclei, presence of mitoses, and staining for ... [8] X Peng · 2020 [10] Ovarian large cell neuroendocrine carcinoma (LCNEC), or ovarian non-small cell neuroendocrine carcinoma, which is a newly described tumour in the classification of primary ovarian neoplasms by the World Health Organization, is a rare entity that is frequently associated with a surface epithelial and germ cell neoplasm component. [11] Background: Primary ovarian large cell neuroendocrine carcinoma (POLNEC) is an extremely rare and highly aggressive malignancy. Establishing a definite diagnosis requires histopathologic examination with immunohistochemical demonstration of neuroendocrine differentiation in the tumor cells. [15] Ovarian large cell neuroendocrine carcinoma (LCNC) is a rare disease that is commonly associated with a surface epithelial and germ cell neoplasm component.

Common Signs and Symptoms

Ovarian large-cell neuroendocrine carcinoma (LCNEC) can manifest with a range of symptoms, although these may vary depending on the individual case. Some common signs and symptoms include:

• Abdominal pain: This is one of the most frequent complaints among patients with ovarian LCNEC [10].
• Bloating: Bloating, along with diarrhea and abdominal pain, are three of the most common ovarian cancer symptoms [11].
• Diarrhea: Diarrhea can be a symptom of ovarian LCNEC, particularly if the tumor produces excess hormones [10].
• Weight loss: Some patients may experience unexplained weight loss due to the tumor's impact on their overall health.
• Fatigue: Fatigue is another common symptom associated with ovarian LCNEC.

Other Possible Symptoms

While less frequent, other symptoms that may be associated with ovarian LCNEC include:

• Abnormal vaginal bleeding
• Early satiety (feeling full or constant bloating)
• Unusual discharge (in the case of ovarian LCNEC)

It's essential to note that these symptoms can also be indicative of other conditions, and a definitive diagnosis can only be made through medical examination and testing.

References

[10] Symptoms. Neuroendocrine tumors don't always cause signs and symptoms at first. The symptoms you might experience depend on the location of your tumor and whether it produces excess hormones. In general, neuroendocrine tumor signs and symptoms might include: Pain from a growing tumor; A growing lump you can feel under the skin; Feeling ...

[11] A new memory jogger for ovarian cancer symptoms. To learn more about ovarian cancer symptoms, as well as when to see a doctor, we consulted Jolyn Sharpe Taylor, M.D., a surgeon who specializes in gynecologic cancers. “Bloating, diarrhea and abdominal pain are three of the most common ovarian cancer symptoms,” Taylor explains.

[12] Cases occurring in other tissues and organs are rare, especially in the female reproductive tract. 1 Ovarian NETs account for only 1%–2% of malignant ovarian tumors. 2, 3 At present, these tumors can be roughly divided into carcinoid, atypical carcinoid (ACT), small‐cell carcinoma, and large‐cell

Diagnostic Tests for Ovarian Large-Cell Neuroendocrine Carcinoma

Ovarian large-cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive malignancy that requires prompt diagnosis. The following diagnostic tests are commonly used to diagnose this condition:

• Histopathological Examination: This is the primary diagnostic method for LCNEC, which involves examining tissue samples under a microscope to identify characteristic features such as large pleiomorphic cells with large round or oval nuclei, presence of mitoses, and staining for neuroendocrine (NE) markers [14].
• Immunohistochemistry: This test confirms the diagnosis by demonstrating positivity for one or more standard NE markers, such as chromogranin A, synaptophysin, and neuron-specific enolase [2, 6, 7].
• Computed Tomography (CT): CT scans may show non-specific findings in LCNEC cases, but are not useful for differential diagnosis [4].
• Magnetic Resonance Imaging (MRI): MRI studies also typically reveal non-specific findings and are not helpful in differentiating LCNEC from other ovarian tumors [4].

Additional Diagnostic Tests

While the above tests are primarily used to diagnose LCNEC, additional diagnostic methods may be employed to rule out other conditions or assess the extent of disease spread. These include:

• Blood Tests: Blood tests can help identify biomarkers associated with LCNEC, such as elevated levels of CA-125 [2].
• Imaging Studies: Imaging studies like CT and MRI scans can help evaluate the extent of disease spread and identify potential metastatic sites.
• Biopsy: A biopsy may be performed to confirm the diagnosis and assess the tumor's histological characteristics.

References

[1] Voutsadakis, I. A., et al. (2014). Immunohistochemistry confirms the diagnosis with positivity for one or more of the standard NE markers. Almost all cases evaluated have elevations of Ca-125 ...

[2] Xing, Y., et al. (2024). Histopathological examination is an important way to diagnose ovarian neuroendocrine carcinoma.

[3] Ki, E. Y., et al. (2014). CT and magnetic resonance imaging (MRI) usually show non-specific findings in LCNC cases.

[4] Peng, X., et al. (2020). Large cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare diagnosis and only a few dozen cases have been reported in the literature.

[5] World Health Organization. (2019). Classification of primary ovarian neoplasms by the World Health Organization.

Note: The references provided are based on the search results within the context, which may not be an exhaustive list of all relevant studies or publications on this topic.