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Agarwal K, Singhai A, Babu S, Singh K, Mishra A. A Case of Krukenberg Tumor: Revealing an Infrequent Primary Site. Indian J Surg Oncol 2023; 14:793-795. [PMID: 38187862 PMCID: PMC10768543 DOI: 10.1007/s13193-023-01782-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/06/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Krachi Agarwal
- Department of Pathology, King George’s Medical University, Lucknow, 226003 UP India
| | - Atin Singhai
- Department of Pathology, King George’s Medical University, Lucknow, 226003 UP India
| | - Suresh Babu
- Department of Pathology, King George’s Medical University, Lucknow, 226003 UP India
| | - Kulranjan Singh
- Department of Endocrine Surgery, King George’s Medical University, Lucknow, 226003 UP India
| | - Anand Mishra
- Department of Endocrine Surgery, King George’s Medical University, Lucknow, 226003 UP India
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Affiliation(s)
- Bifica Sofia Lyngdoh
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Pathology. Shillong, India
| | - Biswajit Dey
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Pathology. Shillong, India
| | - Jaya Mishra
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Pathology. Shillong, India
| | - Evarisalin Marbaniang
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Department of Pathology. Shillong, India
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Tateishi A, Nakashima K, Hoshi K, Oyama Y, Ebisudani T, Misawa M, Aoshima M. Pulmonary Tumor Thrombotic Microangiopathy Mimicking Inhalation Lung Injury. Intern Med 2019; 58:1311-1314. [PMID: 30626821 PMCID: PMC6543225 DOI: 10.2169/internalmedicine.1796-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a complication characterized by dyspnea, pulmonary hypertension, and occasionally sudden death. We encountered a man who developed PTTM and had an inhalation history of chemical herbicides and abnormal findings on chest computed tomography, mimicking chemical inhalation lung injury. He was diagnosed with PTTM with adenocarcinoma by a transbronchial lung biopsy and received chemotherapy and anticoagulant therapy. He survived for one month. An autopsy revealed primary gastric cancer with PTTM that can have a presentation similar to diffuse pulmonary diseases, including chemical inhalation lung injury. The examination of a biopsy specimen is crucial in such patients.
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Affiliation(s)
| | - Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Japan
| | - Kazuei Hoshi
- Department of Pathology, Kameda Medical Center, Japan
| | - Yu Oyama
- Department of Oncology Medicine, Kameda Medical Center, Japan
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Tanaka M, Takahashi K, Kurihara Y, Yamamoto-Rikitake M, Ogusu S, Hirakawa H, Sadamatsu H, Komiya K, Nakamura T, Sueoka-Aragane N. Signet Ring Cell Carcinoma of Unknown Primary Complicated with Pulmonary Tumor Thrombotic Microangiopathy and Krukenberg Tumor. Case Rep Oncol 2018; 11:412-417. [PMID: 30057535 PMCID: PMC6062666 DOI: 10.1159/000490528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 12/14/2022] Open
Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare disease that shows hypoxia with severe pulmonary hypertension related to malignant tumor. Diagnosis is difficult due to rapid clinical progression and the need to demonstrate pathological findings from lung biopsy. A 64-year-old woman visited our hospital with hypoxia and pulmonary hypertension. Diffuse granular shadows in the centrilobular area and ground-glass shadows in both lungs and left ovarian tumor were found on radiological imaging. PTTM was suspected, but pulmonary artery blood aspiration by right cardiac catheter failed to detect cancer cells. We could not obtain lung or ovary biopsies because of hypoxia or pulmonary hypertension. The patient died due to respiratory failure. Signet ring cell carcinoma of unknown primary, PTTM, and Krukenberg tumor were diagnosed on autopsy. Since early diagnosis facilitates adequate treatment, physicians should not miss the opportunity for biopsy in cases of suspected PTTM.
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Affiliation(s)
- Masahide Tanaka
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Koichiro Takahashi
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuki Kurihara
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | | | - Shinsuke Ogusu
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Haruki Hirakawa
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hironori Sadamatsu
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Kazutoshi Komiya
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Tomomi Nakamura
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Naoko Sueoka-Aragane
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
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KARAGÜL S, SÜMER F, ONUR A, TARDU A, DAĞLI AF, KAYAALP C. A case of Krukenberg tumor, eight years after treatment of gastric cancer. MARMARA MEDICAL JOURNAL 2018; 31:81-84. [DOI: 10.5472/marumj.430802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Krukenberg tumor is a rare metastatic tumor of the ovary. Theprimary tumors are usually gastrointestinal cancers. Most of theKrukenberg tumors reported in the literature occurred within thefirst 2 years after treatment of the primary disease. Herein, wepresent a case of Krukenberg tumor in a 37-year-old woman whopreviously underwent surgery and chemotherapy for stomachcancer. This patient is noteworthy because it is one of the fewdocumented cases of ovarian metastasis appearing after a diseasefreeperiod of 8 years following treatment of the primary tumor.Krukenberg tumors are associated with poor prognosis; therefore,regular gynecological examination in female patients with historyof gastric cancer is very important for the early diagnosis andtreatment of this disease.
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Nowacki M, Grzanka D, Zegarski W. Pressurized intraperitoneal aerosol chemotheprapy after misdiagnosed gastric cancer: Case report and review of the literature. World J Gastroenterol 2018; 24:2130-2136. [PMID: 29785081 PMCID: PMC5960818 DOI: 10.3748/wjg.v24.i19.2130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/22/2018] [Accepted: 03/30/2018] [Indexed: 02/06/2023] Open
Abstract
We report the first application of pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-year-old woman with peritoneal carcinomatosis who was primarily diagnosed with and underwent surgery for a Krukenberg tumor. The PIPAC procedure was performed with the use of cisplatin at 7.5 mg/m2 and doxorubicin at 1.5 mg/m2 for 30 min at 37 °C. Eight weeks after the PIPAC procedure, the patient underwent open classic D2 gastrectomy with the creation of a Roux-en-Y anastomosis (RNY) combined with liver metastasectomy. The patient underwent the classic protocol for chemotherapy combined with Xeloda. The patient felt better and returned to her daily activities. Multicenter data should be gathered to confirm the usefulness of PIPAC as a rescue or neoadjuvant supportive therapy in a very select group of patients who have been recently qualified to undergo classic chemotherapy or standard oncologic surgical procedures.
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Affiliation(s)
- Maciej Nowacki
- Department of Surgical Oncology, Ludwik Rydygier’s Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital in Bydgoszcz, Bydgoszcz 85-796, Poland
| | - Dariusz Grzanka
- Department of Clinical Pathomorphology, Ludwik Rydygier’s Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz 85-094, Poland
| | - Wojciech Zegarski
- Department of Surgical Oncology, Ludwik Rydygier’s Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital in Bydgoszcz, Bydgoszcz 85-796, Poland
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Spinelli C, Liloia C, Piscioneri J, Ugolini C, Strambi S. An Unusual Evolution of Krukenberg Tumour: A Case Report. J Clin Diagn Res 2016; 10:PD07-PD11. [PMID: 27891398 PMCID: PMC5121736 DOI: 10.7860/jcdr/2016/20299.8747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022]
Abstract
Krukenberg tumours are rare metastatic tumours of the ovaries characterized by the presence of mucin-producing neoplastic Signet Ring Cell Carcinoma (SRCC). At first glance, this tumour may be confused with a primary ovarian tumour. Surgery and chemotherapy combination have led to improvement in prognosis, but it still remains severe. We report the case of a 60-year-old woman with a Krukenberg tumour rising from a low differentiated gastric adenocarcinoma. The patient was clinically stable for 26 months after surgery until she experienced a prompt decline and died of cerebral haemorrhage within two weeks. The aim of this article was to give an overview of the Krukenberg tumour starting from our case report and comparing it with clinicopathological characteristics of this pathology derived from a review of recent literature.
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Affiliation(s)
- Claudio Spinelli
- Professor, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, Chair of Pediatric Surgery, University of Pisa, Italy
| | - Concetta Liloia
- Assistant Professor, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, Italy
| | - Jessica Piscioneri
- Assistant Professor, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, Italy
| | - Clara Ugolini
- Assistant Professor, Department of Laboratory Medicine and Integrated Diagnostics, Section of Experimental Pathology, University of Pisa, Italy
| | - Silvia Strambi
- Assistant Professor, Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, Italy
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Lee SH, Lim KH, Song SY, Lee HY, Park SC, Kang CD, Lee SJ, Choi DW, Park SB, Ryu YJ. Occult gastric cancer with distant metastasis proven by random gastric biopsy. World J Gastroenterol 2016; 22:4270-4274. [PMID: 27122678 PMCID: PMC4837445 DOI: 10.3748/wjg.v22.i16.4270] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/10/2015] [Accepted: 01/18/2016] [Indexed: 02/06/2023] Open
Abstract
Krukenberg tumor, a rare metastatic ovarian tumor arising from gastrointestinal adenocarcinoma mainly, tends to occur in premenopausal females. Finding the origin of a Krukenberg tumor is crucial for determining prognosis. In Eastern countries, the most common origin of Krukenberg tumor is stomach cancer, which is generally diagnosed via endoscopic biopsy to investigate an abnormal mucosal lesion. Here, we describe a case of huge adnexal mass in a 33-year-old woman who presented with abdominal distension. Two independent endoscopic examinations performed by experts in two tertiary university hospitals revealed no abnormal mucosal lesion. The patient was diagnosed with a Krukenberg tumor according to findings from random endoscopic biopsies taken from normal-looking gastric mucosa in our hospital. It is very rare to be diagnosed via a random biopsy in cases where three well-trained endoscopists had not found any mucosal lesion previously. Thus, in this case, random biopsy was helpful in finding the origin of a Krukenberg tumor.
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Shah B, Tang W, Karn S. An Up-to-Date Understanding of the “Krukenberg Tumor” Mechanism. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/arsci.2016.42005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Patel SA. The inferior vena cava (IVC) syndrome as the initial manifestation of newly diagnosed gastric adenocarcinoma: a case report. J Med Case Rep 2015; 9:204. [PMID: 26411979 PMCID: PMC4584485 DOI: 10.1186/s13256-015-0696-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 08/26/2015] [Indexed: 12/15/2022] Open
Abstract
Introduction Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma. Case presentation A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presented with lower extremity edema and progressive fatigue of 1 month’s duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma. Conclusions This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.
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Affiliation(s)
- Shyam A Patel
- Department of Medicine, Stanford Hospital and Clinics, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.
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