Strumal Carcinoid Tumor of the Ovary

The document reports the case of a 63-year-old white woman with a history of psychosis, hypothyroidism, and breast carcinoma, who was referred to dermatology for ulcerated skin lesions and suspected hyperandrogenemia due to symptoms such as hirsutism, androgenic alopecia, and increased sexual pilosity. Hyperandrogenemia was confirmed with a high plasma testosterone level of 1.7 ng/mL (normal < 0.8 ng/mL). A computed tomography scan revealed a 14 × 11 cm left ovarian mass, which was surgically removed and pathologically identified as a strumal carcinoid tumor of the ovary, containing both carcinoid and abnormal thyroid tissue. After the surgery, the patient's testosterone level normalized, and the hypertrichosis disappeared. One year post-surgery, the patient was reported to be alive and well. Strumal carcinoid of the ovary is a rare ovarian teratoma composed of thyroid and carcinoid tissues, and in the largest series of 50 patients, only 8% showed clinical signs of androgen production. The condition is almost always benign when confined to the ovary, and oophorectomy or salpingo-oophorectomy is an effective treatment.