Abstract
A Krukenberg tumor is a rare and potentially deadly cause of elevated serum β-hCG as part of a paraneoplastic syndrome. This study aims to describe the unusual case of a 36-year-old woman that presented to the Emergency Department (ED) with back pain and a positive urine pregnancy test. Assessment revealed no intrauterine pregnancy and a small left ovarian cyst. Further investigation showed moderately differentiated gastric adenocarcinoma with distant metastases to the spine. The patient died less than 3 months after her first presentation to the ED. Paraneoplastic syndrome, albeit rare, should be considered in the differential diagnosis of elevated β-hCG due to the high mortality associated with Krukenberg tumors.
Highlights
Krukenberg tumor is an ovarian adenocarcinoma metastasis from a primary malignancy of the gastrointestinal tract with 76% originating from the stomach [1]
Case We present the case of a 36 year old G4P4 Hispanic female who presented to the Emergency Department (ED) for nausea, vomiting, diarrhea, 30 pound weight loss over 2–3 months, generalized body aches most pronounced in the lower back for 5 days, and a positive pregnancy test
Physicians should be aware that elevated β-Human chorionic gonadotropin (hCG) can be found in conditions outside of pregnancy and can be associated with malignancy
Summary
Krukenberg tumor is an ovarian adenocarcinoma metastasis from a primary malignancy of the gastrointestinal tract with 76% originating from the stomach [1]. It is bilateral in 80% of the cases [1]. The eponym comes from the description of 5 cases by Friedrich Krukenberg (1871–1946) in 1896 [1] He described it as common in young women, presenting with ascites, uneven knobby ovarian surfaces, and lymphatic involvement [1]. The differential diagnosis includes ectopic pregnancy, germ cell ovarian tumors, gestational trophoblastic neoplasia including hydatiform mole and placental site trophoblastic tumors [2], phantom hCG resulting from interference in serum testing [2], and
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