Mixed adenoneuroendocrine carcinomas are more aggressive tumors. The presenting symptoms are nonspecific and the primary source is often unidentified. Since the patient had a history of krukenberg tumor, and exhibited. Resection to no residual disease absence of extraovarian disease the origin of the primary tumor patients with krukenberg tumors in the context of gastric cancer have a poorer outcome than those with colon cancer. Kt is typically characterized by mucin secreting signet ring cell adenocarcinoma lying in the fibroblastic. Disseminated cancer presenting in pregnancy is extremely rare and its presentation can easily be obscured by pregnancy and physiological changes that occur with it. In the mother, basal hormonal studies were done 1 and 4 weeks after delivery, then after. Download as pptx, pdf, txt or read online from scribd. Krukenberg tumours are not a common disease entity, forming 12% of all ovarian tumours. Her survival was 24 months after the first intervention.
Clinical characteristics and prognostic analysis of. Dec 12, 2018 medical definition of krukenberg tumor. Gastric adenocarcinoma, especially at the pylorus, is the most common source. The covariates used for survival analysis were patient age at the time of ovarian relapse categorized as 50 years, size of krukenberg s tumor categorized as 10 cm, initial ajcc stage of gastric carcinoma, relapsefree interval categorized as 2 years, extent of recurrent disease, and the.
Mixed adenoneuroendocrine carcinoma is a rare tumor recently recognized as a new category in the last world health organization who classification of appendiceal tumors 2010. In ckt, single signet ring cells predominated over lumen. Krukenberg tumor secondary to lung adenocarcinoma archivos. Files are available under licenses specified on their description page.
Carcinomas of colon, appendix, and breast mainly invasive lobular carcinoma are the next most common primary sites 2. The eponym comes from the description of 5 cases by friedrich krukenberg 18711946 in 1896. It is of yet unclear origin, but it is assumed to be of a mesothelial origin based on its tendency for widespread metastasis in serosal linings. Krukenberg amputation definition of krukenberg amputation. Symptoms usually dont present until advanced stages of disease, when jaundice is the most common feature. Krukenberg tumor is an ovarian adenocarcinoma metastasis from a primary malignancy of the gastrointestinal tract with 76% originating from the stomach. Krukenberg tumor kt is a rare metastatic ovarian tumor mostly originating from gastrointestinal gi malignancy, and accounts for 12% of all ovarian tumors. Here we report a case of virilization associated with an extensive. This study aims to describe the unusual case of a 36yearold woman that presented to the emergency department ed with back pain and a positive urine pregnancy test.
It remains in use today for certain special cases but is considered controversial and some surgeons refuse to perform it. Cases of primary colorectal cancer metastasizing to the ovaries are not. Krukenberg tumor is a rare metastatic signet ring cell tumor of the ovary, accounting for 12% of all ovarian tumors. Krukenberg tumor is more commonly observed among women in their fifth decade of lives, with an average around 45 years of age. The treatment of metachronous krukenberg tumor mkt from gastric cancer remains unexplored. Concerning the prognosis of krukenberg tumor, the radical resection of krukenberg tumor without leaving macroscopic residual lesions is difficult in many cases, and it has been reported that the median duration of survival ranges from 7. Diagnostic problem schiller emphasized that this, also, was a poor choice, because the name was used loosely to include all varieties 01 metastatic carcinoma to the ovary. Credit for the recognition of this rare entity belongs to dr ibrahim ramzy 33 who first described, in 1976, the occurrence in a cellular stromal neoplasm of signet ringlike cells figure 1, e but which lacked the mucin of such cells in a krukenberg tumor or the lipid of the signet ringlike cells seen in the sclerosing stromal tumor. Assessment revealed no intrauterine pregnancy and a small left ovarian cyst. The majority of patients with krukenberg tumor remain asymptomatic or have nonspecific gastrointestinal symptoms. The development of the krukenberg tumor is not from general gastric cancer, but it is a specific form of cancerous growth arises from signet ring cell carcinoma of the stomach and spread to adenocarcinoma of the ovary.
Krukenberg tumor kt is a rare metastatic ovarian tumor originating from other malignancy. Mechanism of the androgen overproduction in this exceptional condition is still poorly understood. Krukenberg tumor is a metastatic malignant tumor of the ovary arising from a wide variety of primary sources, with the stomach being the most common. Approach to the mechanism of androgen overproduction in a. Elles sont rares et representent 1 a 2 % des tumeurs ovariennes. Kt is related to severe prognosis due to its aggressiveness, diagnostic difficulties and poor treatment efficacy.
This case describes a patient who was diagnosed incidentally following investigations for preeclampsia. Pdl1 expression predicts a distinct prognosis in krukenberg tumor. Occasionally krukenberg tumors have endocrine function and, as a consequence, some patients demonstrate hirsutism and virilization. Krukenberg tumor definition of krukenberg tumor by medical. Krukenberg tumor is a metastatic cancerous development spread from stomach to ovary. Is a surgical approach justified in metachronous krukenberg tumor. Krukenberg tumor presenting as back pain and a positive. Krukenberg tumors are often over 80% found in both ovaries, consistent with its metastatic nature.
May 10, 2012 clear cell carcinoma clear cell ovarian tumors are part of the surface epithelial tumor group of ovarian cancers, accounting for 6% of these cancers. Historical perspective, general principles, mucinous tumors including the krukenberg tumor. Krukenberg tumor kt is a rare secondary ovarian tumor, primarily localized at the gastrointestinal tract in most cases. In terms of their pathologic features, disease course, and prognosis, serous and mucinous ovarian. Stomach is the primary site in most krukenberg tumors 70%. H e proposed, instead, a krukenberga s metastatic ovarian carcinoma. Krukenberg tumor survival rate, prognosis, symptoms, treatment. The krukenberg procedure, also known as the krukenberg operation, is a surgical technique that converts a forearm stump into a pincer. Krukenberg tumor presenting as back pain and a positive urine. A case of virilization induced by a krukenberg tumor from. In order to analyze the clinical characteristics and prognostic factors, we retrospectively investigated 128 patients who were diagnosed with krukenberg tumor between january, 1990 and december, 2010.
It usually also accompanies with cholelithiasis incidence is 12% and incidentally detected by radiologic examination such as ultrasound, computed tomography or intra. A krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast. Jul 12, 2017 krukenberg tumor in a 22 year old patient with primary tumor in the transverse colon. We analyzed a total number of 116 patients diagnosed with metastasis to the ovary between 1985 and 2007 at the radboud university nijmegen. The tumors represent 510% of all ovarian tumors and up to 50% of all.
Krukenberg tumor is named after friedrich ernst krukenberg who described five cases of krukenberg tumors in 1896 while working as a student in a laboratory in germany. Complication of ovarian tumors torsion common with dermoidfibroma severe abdominal painvomitting rupture. Sep 02, 2015 krukenberg tumor is a rare metastastic tumor of the ovary, characterized by poor prognosis. Krukenberg tumor is a metastatic signet ring cell adenocarcinoma of the ovary, accounting for 1% to 2% of all ovarian tumors. Appendiceal mixed adenoneuroendocrine carcinomas, a rare. Krukenberg tumor in a 22 year old patient with primary tumor.
The diagnosis and origins of kt depends on histopathology and immunohistochemistry evaluation ihc. Metastatic ovarian tumors chapter 9 altcheks diagnosis and. If you have problems viewing pdf files, download the latest version of adobe reader. Since the time of krukenberg in 1896, all ovarian tumors which enlarge the ovaries uniformly without distortion, which present alterations of fibrous areas with mucinouscell groups, and which propagate along the lymphatics are called krukenberg tumors 6. A krukenberg tumor is a rare and potentially deadly cause of elevated serum. Mri features of primary and metastatic mucinous ovarian. Krukenberg carcinoma genetic and rare diseases information. Overall survival curves for the patients with krukenberg tumor. Ct and mr imaging of ovarian tumors with emphasis on. This term has been proposed to designate carcinomas of the appendix that arise by progression from a preexisting goblet cell carcinoid. For language access assistance, contact the ncats public information officer. Clinical characteristics and prognostic analysis of krukenberg tumor. The development of the krukenberg tumor is not from general gastric cancer, but it is a specific form of cancerous growth arises from signet ring cell carcinoma of the stomach and spread to adenocarcinoma of the ovary the primary place of development of the krukenberg tumor is the stomach, but other primary.
Krukenberg tumor, also known as carcinoma mucocellulare, refers to the signet ring subtype of metastatic tumor to the ovary. Klatskin tumors are are a type of cholangiocarcinoma that begins in an area called the hilum, where the left and right bile ducts join and leave the liver. Figure 2 from early gastric cancer with krukenberg tumor and. Krukenberg tumor article about krukenberg tumor by the free.
The krukenberg tumor is a mysterious ovarian metastasis of digestive tract cancer accounting from 1 to 2% of all. Gallbladder cancer is unusually seen but can result in highly mortality rate. To evaluate the frequency of metastatic tumors among malignant ovarian neoplasms, the site distribution of the primary malignancies that give rise to ovarian metastasis and the clinicopathologic features of metastatic tumors. Klatskin tumor genetic and rare diseases information. Appendiceal mixed adenoneuroendocrine carcinomas, a rare entity that can present as a krukenberg tumor. The ultrastructural, histochemical, and immunohistochemical characteristics of 12 classical signet ring cell krukenberg tumors ckt and three tubular krukenberg tumors tkt were evaluated and related to their possible influence on the ovarian stroma. They are in most instances bilateral and produce a. In this report, we describe a young female who presented with bilateral ovarian masses that mimicked the classic clinical picture of ovarian cancer. Krukenbergs tumor article about krukenbergs tumor by the. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Several treatments have been used, such as cytoreductive surgery crs, adjuvant chemotherapy ct andor hyperthermic intraperitoneal chemotherapy hipec. It makes challenge to diagnose for clinicians due to present asymptomatic or nonspecific clinical presentation including abdominal pain, anorexia. From mucin secreting tumors, stomach and colon krukenberg tumors may be secondary to breast 39. Krukenberg tumor is typically free of surface adhesions or peritoneal deposits unlike other ovarian metastasis.
The krukenberg tumor represents ovarian metastases associated with gastric cancer or other gastrointestinal malignancies. He described it as common in young women, presenting with ascites, uneven knobby ovarian surfaces. Primary desmoplastic smallroundcell tumor of the ovary. The two most common types of epithelial neoplasms are serous and mucinous tumors, 7. A case of virilization induced by a krukenberg tumor from gastric. All structured data from the file and property namespaces is available under the creative commons cc0 license. These tumors occur with greatest frequency in women about the age of thirtyfive. A case report of krukenberg tumor s secondary to adenocarcinoma of gall bladder also, ovarian metastases, including krukenberg tumors, may be mistaken as a solid sexcord stromal tumor and can appear as solid or complex ovarian. Ovarian metastases from gallbladder mimics primary ovarian. Krukenberg tumor arising from bilateral lobular carcinoma in. Krukenberg tumor medical definition merriamwebster. The overall survival in our patients was two months. It is the most common type of cholangiocarcinoma, accounting for more than half of all cases.
Krukenberg tumor survival rate, prognosis, symptoms. Histology shows typical mucusproduction and numerous signetring cells. Desmoplastic smallroundcell tumor dsrct is an extremely rare and highly aggressive malignancy. The colon and stomach are the most common primary tumors to result in ovarian metastases, followed by the breast, lung, and contralateral ovary. Treatments and overall survival in patients with krukenberg tumor. Virilization may occur during pregnancy as the result of an ovarian krukenberg tumor. Here we report a case of virilization associated with an.
On microscopic examination, composed of cells with clear cytoplasm that contains glycogen hob nail cells. A tumor of the ovary that is caused by the spread of metastatic cancer of the gastrointestinal tract. Despite initially being thought to be of low risk, the final diagnosis was that of metastasis from a primary cancer of an. Krukenberg tumor in a 22 year old patient with primary. It was first described in 1917 by the german army surgeon hermann krukenberg. Epithelial tumors are typically primarily cystic, may be either unilocular or multilocular, and, when malignant, are associated with varying proportions of solid tissue, 6.
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