Fig. 2

a–d Metastatic ovarian carcinoid of unknown primary origin in a 23-year-old female complaining of pelvic pain and amenorrhoea. Sagittal T2-weighted MR image (a) and axial T1-weighted MR image with fat saturation, after intravenous gadolinium administration (b). Large, well-defined solid lesion of the left ovary, cranially and anteriorly located in relation to the uterus. On T2WI, it displays intermediate signal intensity and shows a central high signal region. The lesion shows peripheral, intense contrast enhancement and a large central area of necrosis. Inferiorly to the solid tumour, a large simple cyst is found. A small amount of ascites is found in the cul-de-sac. H&E section of the ovary occupied by a tumour with insular pattern composed by neuroendocrine cells (c). These cells have intense cytoplasmatic staining for synaptophysin (d) and have small chromogranine-positive granules in the cytoplasm (not shown)