Understanding the Rare Krukenberg Tumor: A Current Review

Abstract

Krukenberg tumors represent a rare type of secondary ovarian tumors composed of mucinous signetring cells. In up to 70% of cases the primary site is a diffuse type gastric carcinoma, which disseminates to the ovary through a retrograde lymphatic pathway. The Krukenberg tumor is a good example of metastatic ovarian organotropism (“seed and soil” hypothesis).The symptoms are nonspecific and usually don’t develop until the tumors reach a certain size. The definitive diagnosis can only be made histologically after surgical resection, although imaging findings can indirectly aid in the distinction between benign-malignant and primary-secondary tumors. Immunohistochemistry is the most important diagnostic method in distinguishing primary from secondary ovarian neoplasms, and can usually detect the tissue of origin. The extremely dismal prognosis of Krukenberg tumors is attributed to the fact that they represent an advanced stage metastatic disease. Although the standard treatment is systemic chemotherapydepending on the primary site, there are rough indications that cytoreductive surgery might prolong survival in selected patients.