Abstract
We experienced a very rare case of intramucosal early gastric cancer which metastasized to be bilateral ovaries, peritoneum, pleura, pericardium and many lymph nodes. A 46-year-old woman was referred to our division of gynecology because of a large tumor of the lower abdo-men. During operation bilateral enlarged ovaries were found and a biopsy specimen from an ovary was diagnosed as signet-ring cell carcinoma. A washing cytology was class V. Massive bilateral Krukenberg tumors and the uterus were resected, but no primary lesion was found except the regional lymph node metastases around the stomach. Thereafter an intramucosal II c lesion was found in the lower body of the stomach. It was signet-ring cell carcinoma histologically. A surgical mucosectomy was performed and the lesion was confirmed to be an intramucosal signet-ring cell carcinoma without lymphatic permeation or venous invasion. A dual histochemical stain with galactose oxidase-cold thionim Schiff (GOCTS) procedure and then with para-doxical concanavalin A staining (PCS) revealed that Krukenberg tumors were metastatic foci from the gastric cancer.
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