Case Of Krukenberg Tumor Research Articles

S3566 Birthing a Baby or Surfacing a Hidden Tumor?

Introduction: Malignancy is a rare finding during pregnancy and if present, often carries poor prognosis. We present to you a case of Krukenberg tumor- a metastatic malignancy of the ovary- in a 29 year old female. Case Description/Methods: A 29-year-old female with no past medical history, presented to the hospital with preterm labor at 30 weeks gestation which lead to low transverse caesarian delivery secondary to recurrent prolonged decelerations and preterm contractions. Patient had an uneventful pregnancy course until this hospitalization. Intraoperatively, a large right sided ovarian mass was discovered. Tissue pathology revealed metastatic poorly differentiated adenocarcinoma. CT scan of the abdomen pelvis was suggestive of right adnexal mass measuring 10 × 14 × 13 cm with increased vascularity, large degree of abdominal pelvic ascites, with few lymph nodes in the upper mesenteric arcade, along with moderate thickening of the gastric wall. Esophagogastroduodenoscopy (EGD) revealed a gastric mass at cardia (Figure a), and tissue pathology was consistent with adenocarcinoma with presence of signet ring cells (Figure b). Additional work up was positive for elevated CA 125 and AFP tumor marker measuring 355 U/ml and 10.8 U/ml, respectively. Subsequent follow up with CT abdomen revealed bilateral ovarian metastasis with large volume ascites. Diagnostic paracentesis was negative for malignant ascites. Clinical course was complicated by recurrent ascites and progressive clinical deterioration. Due to poor performance status, the patient did not undergo any surgical intervention. Patient is currently being managed with palliative chemotherapy and paracentesis for symptomatic relief. Discussion: Krukenberg tumor is a metastatic malignancy of the ovary which is characterized by mucin-rich signet-ring adenocarcinoma that arises primarily from a gastrointestinal site. It accounts for almost 1%–2% of all ovarian tumors. The incidence of gastric cancer in the women of reproductive age group is 0.4%–0.5%, making these tumors extremely rare during pregnancy. Pregnancy symptoms masks the presence of the disease leading to diagnosis at a later stage. Unfortunately, no optimal treatment strategy for these tumors have been identified so far. Chemotherapy as well as radiation therapy does not seem to have any significant role in the prognosis of these patients. Due to metastatic nature and lower rate of resectability, surgery is deferred as it does not offer any increased survival time. The overall prognosis remains poor.Figure 1.: (a) EGD revealing gastric mass at cardia (b) Tissue pathology showing adenocarcinoma with presence of signet ring cells.

Krukenberg tumors of the ovary Rectal origin

Krukenberg tumors (TK) define themselves as ovarian metastases from cancer more often digestive. These are rare tumors that represent 1 to 2% of ovarian tumors. They are characterized by the presence of “kitten ring” cells filled with mucus and a pseudo-sarcomatous proliferation of the ovarian stroma. Their evolution is quickly fatal. We report 1 case of Krukenberg tumor observed and operated on in June 2020 at the surgery Department B CHU Constantine. The symptoms began with a rectal syndrome with transient episodes of pelvic pain. In this regard, we will recall the epidemiological, clinical, and evolutionary characteristics of this disease. Keywords: Krukenberg tumor, rectal cancer, ovarian metastases, synchronous tumors, posterior pelvectomy.

Krukenberg Tumor with Leptomeningeal Carcinomatosis Misdiagnosed as Acoustic Neuroma

Objective: Leptomeningeal carcinomatosis (LMS) is defined as the diffuse infiltration of the leptomeninges and subarachnoid space by malignant cells metastasizing from systemic cancer. Patients usually have a known underlying malignancy, but primary presentation can be with symptoms of meningeal involvement. We describe a rare case of Krukenberg tumor with LMS initially presented as bilateral progressive sensorineural hearing loss, which was misdiagnosed as acoustic neuroma. Patient: A 50 year old man with a history of cervical cancer was referred to the Ear Nose and Throat (ENT) clinic because of progressive hearing loss, tinnitus, dizziness and blurred vision for 5 months. Results: A CT scan of the abdomen and pelvis showed a right adnexal mass, suspicious for an ovarian neoplasm. The patient underwent surgical resection of her pelvic mass. Surgical pathology revealed poorly differentiated adenocarcinoma with scattered signet ring cells, favorable with metastatic gastric adenocarcinoma. Magnetic resonance imaging revealed abnormal leptomeningeal enhancement. A lumbar puncture was performed, the CSF analysis showed elevated protein and positive for signet malignant cells. Conclusion: Our case highlights the importance of the development of new diagnostic tools and treatment regimens for LMC.

Treatment of Krukenberg tumor with hyperthermic intraperitoneal chemotherapy: A report of three cases

We report three cases of Krukenberg tumor (KT): two were synchronous and one metachronous. At presentation, the first synchronous KT patient had a palpable umbilical mass, the second had a perforated peptic ulcer, and the metachronous KT patient had an ovarian lesion, detected postoperatively. As we know, KT has a quite poor prognosis. According to some papers, surgery with chemotherapy increases survival more than 12 months. Consequently, our two synchronous KT patients received cytoreductive surgery with hyperthermic intra-abdominal chemotherapy and our metachronous KT patient received laparoscopic bilateral oophorectomy. No recurrences have so far been detected in any patient. Our patient with metachronous KT will undergo laparoscopy and hyperthermic intraperitoneal chemotherapy and our patients with synchronous KT will continue to be followed up to determine their final outcomes.

Imaging modalities in the differentiation of various adnexal lesions

Aim The purpose of this study was to discuss the role of different imaging modalities in the diagnosis and evaluation of adnexal masses. Patients and methods A total of 50 female patients with 60 adnexal lesions were included in his study. After clinical evaluation, ultrasound examination was carried out for all cases. After observing all gray scale features, color Doppler was superimposed on the gray images to assess the site of blood flow and measure the Doppler indexes. Computed tomography was performed in seven suspicious cases, and MRI was performed in eight suspicious cases. The results were correlated with operative and histopathological findings. Results Nine malignant cases had Alcazar score greater than 6, whereas the benign cases (41 cases) had a score less than 6. There were two cases (4%) of hydrosalpinx, five cases (10%) of ectopic pregnancy, three cases (6%) of tuboovarian abscess, four cases (8%) of polycystic ovaries, and four cases of solid masses (8%) (one case of ovarian fibroma, one case of subserous uterine fibroid, one case of broad ligament fibroid, and one case of Krukenberg tumor). There were 24 cases of cystic masses (48%) either unilocular or multilocular within thin septae (seven cases of follicular ovarian cysts, eight cases of hemorrhagic cysts, one case of corpus luteal cyst, two cases of endometrioma, three cases of dermoid cysts, two cases of serous cystadenoma, and one case of paraovarian cyst). There were eight complex masses (16%) (one case of granulosa cell tumor, one case of dysgerminoma, one case of papillary carcinoma, one case of metastasis, two cases of serous cystadenocarcinoma, and two cases of mucinous cystadenocarcinoma). Conclusion Using ultrasound and color Doppler studies with scoring system was found to be useful in differentiating a benign from a malignant adnexal mass. Computed tomography scan has shown to be beneficial in assessing the disease extent and planning for treatment. MRI was beneficial in characterizing adnexal masses in problematic cases.

Long-term oncologic outcomes of 714 consecutive laparoscopic gastrectomies for gastric cancer: results from the 7-year experience of a single institute

Although many reports have indicated the feasibility of laparoscopic gastrectomy (LG) regarding short-term surgical outcomes, the role of LG remains controversial because studies of long-term outcomes of LG are insufficient. The purpose of this study was to evaluate the long-term oncologic outcomes of patients who have undergone LG. Between May 2003 and December 2009, 714 consecutive patients underwent LG for gastric cancer. After excluding operative mortality (n=4) and a case of Krukenberg tumor that was not identified at the time of surgery (n=1), a total of 709 patients were analyzed for long-term oncologic outcomes. Gastric cancer cases were analyzed according to the American Joint Committee on Cancer classification (seventh edition). Overall survival and relapse-free survival were estimated by using the Kaplan-Meier method. Median follow-up was 46.2months. Postoperative recurrence was observed in 26 patients (3.7%). The instances of recurrence were as follows: seven peritoneal, six locoregional, five hematogenous, four distant lymph nodes, and four mixed recurrence. There were neither port-site nor wound site metastases. The 5-year relapse-free survival rates were: 95.8% in stage I, 83.4% in stage II, and 46.4% in stage III. Five-year overall survival rates were: 96.4% in stage I, 83.1% in stage II, and 50.2% in stage III. The independent risk factors for recurrence were T stage and N stage. For survival, age, T stage, and N stage were statistically independent prognostic factors Our single-center study of a large patient series revealed that LG for gastric cancer had acceptable long-term oncologic outcomes comparable to those of conventional open surgery.

A Case of Krukenberg Tumor associated with Ovarian Dermoid Cyst

A Case of Krukenberg Tumor associated with Ovarian Dermoid Cyst

KRUKENBERG TUMORS OF THE OVARY

Abstract The present knowledge and literature on Krukenberg tumors of the ovary are reviewed. Five cases of Krukenberg tumor of the ovary are presented. The first case in this report, that of a girl age thirteen years, is thought to be the youngest patient to be described in the literature with this disease.

クルーケンベルグ氏卵集腫瘍の一例

クルーケンベルグ氏卵集腫瘍の一例

Krukenberg tumor with involvement of the appendix

1.1. The observation is made that metastatic involvement of the appendix, a supposedly rare complication which was found in this case, is probably a more common occurrence than is generally believed. This is probably also true of other structures hitherto considered to be rarely the seat of metastasis in this malady.2.2. Detailed reports of many more cases of Krukenberg tumor than are at present available are necessary in order to solve some of the important problems arising in connection with this neoplasm.

Report of a case of Krukenberg tumor

Report of a case of Krukenberg tumor