Krukenberg tumor complicated by pregnancy

A 32-year-old female presented with a right ovarian mass, and the unilateral oophorectomy specimen revealed adenocarcinoma with signet-ring cells histology consistent with a Krukenberg tumor. The high-grade gastric primary adenocarcinoma was later identified, but by this time a viable 7-week fetus and left ovarian Krukenberg tumor were present. Second trimester palliative oophorectomy and partial gastrectomy were performed. The patient delivered a healthy infant by cesarean section and is now 36 months after the initial diagnosis of metastatic gastric carcinoma and remains asymptomatic and free of disease. The unexpectedly favorable clinical outcome suggests that a patient may benefit from resection of gastric adenocarcinoma metastatic to ovary when other sites of metastatic disease are not evident.

Surgical treatment of Krukenberg tumours: case reports and clinical consideration

The authors present 4 cases of Krukenberg tumour of the ovary, secondary to carcinoma of the stomach (3 cases) and carcinoma of the breast (1 case). Pathologically it is characterized by the presence of typical signet ring cells and a diffuse infiltration of the stroma that gives the appearance of a sarcoma. Clinical data, computed tomography (CT) and sonographic findings in these four cases are analyzed. A review of the literature concerning this condition is provided and the treatment of the disease is discussed emphasizing the role of prophylactic oophorectomy.

[A primary mucus-producing adenocarcinoma of the appendix with a bilateral Krukenberg tumor]

A patient is described with a primary mucous adenocarcinoma of the appendix with bilateral Krukenberg tumours. On the basis of the available literature the value of diagnosing a Krukenberg tumour of the ovaries is elucidated. Finally the question is raised whether this matter should influence policy as regards colorectal tumours.

[Krukenberg's tumor. Apropos of a case. Review of the literature]

A case is reported of krükenberg's tumor, this rare lesion characterized by the constant presence of typical signet ring cells being an ovarian metastasis from a general digestive cancer. The primary neoplasm is often overlooked while the ovarian tumor is already large and bilateral. In a pregnant patient with this lesion virilization of mother and child may occur, this endocrine activity being poorly documented and the subject of a literature review. The pathogenicity of this tumor is still unknown. Endocrine investigations should be enlarged in the fairly rare cases when diagnosis is suspected prior to ovarian excision. Treatment is currently surgical but survival is little improved. Other therapy is only poorly effective.

Krukenberg tumors of the ovary: a clinicopathologic analysis of 27 cases

A series of 27 typical Krukenberg tumors of the ovary were analyzed. By definition, all examples were characterized by the presence of mucinous signet-ring carcinoma cells within a cellular, nonneoplastic ovarian stroma. The patients' ages ranged from 20-70 years; almost one-half were 40 years of age or younger. A primary carcinoma of the stomach (16 cases) or colon (four cases) was found in 20 (90.9%) of 22 patients with available follow-up data. The primary gastrointestinal carcinomas had been diagnosed before emergence of the ovarian tumors in only five cases. The ovarian and gastrointestinal tumors were synchronously diagnosed in ten cases, while in five instances the primary carcinomas were not discovered until after the ovarian tumors had been treated. An acceptable primary extraovarian cancer was not detected in two women. Both had bilateral Krukenberg tumors and died with widespread carcinomatosis less than two years postoperatively. Typically, the ovarian tumors were bilateral, asymmetrically large and solid. Important histologic features included a greater abundance of intracellular neutral glycoproteins than acidic mucins, a storiform pattern of hyperplastic cortical stromal cells (44.4%) and carcinomatous emboli (51.6%). While the entity of "primary" Krukenberg tumor cannot be unequivocally denied, all women with typical Krukenberg tumors should be considered as having metastatic carcinoma, usually from the stomach, until proven otherwise.

Krukenberg tumors of the ovary: a clinicopathologic analysis of 27 cases

A series of 27 typical Krukenberg tumors of the ovary were analyzed. By definition, all examples were characterized by the presence of mucinous signet-ring carcinoma cells within a cellular, nonneoplastic ovarian stroma. The patients' ages ranged from 20-70 years; almost one-half were 40 years of age or younger. A primary carcinoma of the stomach (16 cases) or colon (four cases) was found in 20 (90.9%) of 22 patients with available follow-up data. The primary gastrointestinal carcinomas had been diagnosed before emergence of the ovarian tumors in only five cases. The ovarian and gastrointestinal tumors were synchronously diagnosed in ten cases, while in five instances the primary carcinomas were not discovered until after the ovarian tumors had been treated. An acceptable primary extraovarian cancer was not detected in two women. Both had bilateral Krukenberg tumors and died with widespread carcinomatosis less than two years postoperatively. Typically, the ovarian tumors were bilateral, asymmetrically large and solid. Important histologic features included a greater abundance of intracellular neutral glycoproteins than acidic mucins, a storiform pattern of hyperplastic cortical stromal cells (44.4%) and carcinomatous emboli (51.6%). While the entity of "primary" Krukenberg tumor cannot be unequivocally denied, all women with typical Krukenberg tumors should be considered as having metastatic carcinoma, usually from the stomach, until proven otherwise.

[Krukenberg's tumor of the ovary and uterine myoma]

A case of Krukenberg's tumour of the ovary in a 41-year-old patient is described. A year before admission she had mild gastric trouble, repeated short-lasting amenorrhea followed by prolonged bleeding. The menstruations preceding hospitalization were normal and painless. More serious trouble developed suddenly, four days before admission, in the form of intense pain in the lower abdomen and moderate bleeding. The woman had delivered twice and had 6 abortions. Her mother died of intestinal cancer. On examination, the patient was found to have two tumours: one on the right side, the size of a newborn's head, and one on the left side, the size of a female fist, both kidney-shaped and mobile. Also numerous small knots on the small intestine, peritoneum, and omentum, as well as a considerable amount of ascites were observed. An uterine myoma was found as well. Histerectomy and ablation of both adnexa were performed. The therapy was continued by radiation but the patient died 5 months following the operation.