Introduction Ovarian metastases of gastrointestinal origin, also called Krukenberg tumors, have a guarded prognosis. Physicians need to look for alternatives in diagnosis and treatment for this clinical condition in order to improve the outcome of the patients. Objectives To report the experience of the authors in the treatment of these patients, and to perform a review of the literature on the epidemiology, clinical presentation, diagnosis, treatment, and prognosis for ovarian metastases from colorectal cancer. Methods We collected clinical information regarding the patients treated for ovarian metastasis from colorectal adenocarcinoma at our coloproctology service, and performed a search on the PubMed database using the terms colorectal cancer, ovarian metastasis, Krukenberg tumor and surgery. Conclusion Large abdominal tumors are the most frequent presentation of ovarian metastasis from colorectal cancer. The diagnosis is based on a histopathological analysis, levels of carcinoembryonic antigen (CEA) and cancer antigen 125 (CA-125), and immunohistochemical studies for the cytokeratin 20 (CK20), caudal-type homeobox 2 (CDX2) and vilina markers. Citoreductive surgical procedures are the most promising approach to treatment, with the highest impact on overall survival. The prognosis is negatively influenced by the extent of the metastasis, by citoreductive surgical procedures with persistence of macro- or microscopic foci of the disease, and by low scores on the general well-being index of the patient.

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Introduction: Paget’s disease is a rare condition ocurring in the papillary-areolar complex, and it is associated with carcinoma, representing 0.5%–5% of all types of Breast Cancer (BC). The uniqueness of the case is related by the BC diagnosis during pregnancy, besides the COVID-19 pandemic context and its consequences. Case report: A 37-year-old woman identified a first-trimester pregnancy during preoperative exams of a nipple biopsy, which confirmed Paget’s disease. Due to the pregnancy and considering the COVID-19 pandemic, an expectant conduct follow-up was settled. After eight weeks, the patient at 26-week gestational age referred a breast lump, and a core biopsy confirmed invasive ductal carcinoma. She started treatment with neoadjuvant chemotherapy. After three cycles, the therapy was interrupted because she presented clinically local progression. The interruption of treatment and the pregnancy resolution was made at 36 gestational weeks. Posteriorly, the surgical approach involved mastectomy and axillary limph nodes dissection, followed by adjuvant chemotherapy.

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