Primary infertility associated with neuroendocrine tumor (Carcinoid) of the appendix

Neuroendocrine tumors of the appendix (NET-A), formerly called appendiceal carcinoids, are rare tumors of the gastrointestinal tract. Appendiceal tumors have also been associated with infertility. However, in many of these cases, significant abdominal pathology, specifically pseudomyxoma peritonei, was identified during definitive surgical intervention. A 34-year-old nulligravid woman undergoing infertility evaluation presented to an academic tertiary care fertility center. An abnormal mass was identified on hysterosalpingogram and CT confirmed appendiceal mass. Surgical removal of the mass was performed and histopathology was consistent with an NET-A with negative margins extending to the serosa. Two months after surgical intervention, the patient spontaneously conceived pregnancy and subsequently delivered a normal infant. This case exemplifies the importance of careful inspection of radiologic films by the gynecologic physician. Of added interest, this case describes an asymptomatic NET-A associated with primary infertility. To our knowledge, this is the first report of an incidentally indentified NET-A that resulted in primary infertility.