Color Doppler Sonographic Features of a Krukenberg Tumor in Pregnancy

Abstract

Krukenberg tumor (KT), defined as an adenocarcinoma that metastasizes to the ovary from different primary tumor sites, 1 has an extremely poor prognosis, with a 5-year survival rate ranging from 12% to 23.4%. 2,3 Gastric cancer has been reported as the most frequent primary source responsible for approximately 50% of KTs. 3 A KT from primary gastric carcinoma very rarely complicates pregnancy, and its early diagnosis is often difficult because the persistent gastrointestinal symptoms mimic the nausea and vomiting of pregnancy and can mask the presence of a gastric mass. To our knowledge, the color Doppler sonographic appearance of a KT in pregnancy has been previously described in only 1 case. 4 Here we report a case of a KT secondary to gastric carcinoma in a pregnant woman with only pelvic pain and no gastrointestinal symptoms. The prenatal diagnosis was made at 25 weeks' gestation with color Doppler sonography.A 38-year-old woman, gravida 1, at 25 weeks' gestation was referred to the Department of Obstetrics and Gynecology at Catholic University of Rome because of pelvic pain. Her family history was negative for malignancy, and she had no prior medical or gynecologic illnesses. She had no symptoms of nausea, vomiting, weight loss, or urinary tract difficulties.The patient underwent transabdominal and transvaginal sonography (Voluson I; GE Healthcare, Milwaukee, WI) showing an encapsulated ovoid solid ovarian mass (165 × 87 × 90 mm) with regular margins completely replacing the left adnexa behind the uterus in the Douglas pouch. The right ovary was not evaluable, and no ascites was documented.

Preterm Labor in 29 Weeks Pregnancy with Krukenberg Tumor

“…5 Diğer yandan bazı çalışmalarda; gebelikte ani ortaya çıkan hirsutizm ve/veya virilizasyonun da Krukenberg tümörü ile ilgili olabileceği belirtilmiştir. Ancak gebelikte daha sık görülen ve benign bir lezyon olan luteoma olasılığı nedeni ile tanıda gecikmelere neden olmuştur.…”

Krukenberg tumor in a pregnant patient with severe preeclampsia

“…This is uncommon in primary ovarian tumors and is useful in discriminating Krukenberg tumors from primary ovarian tumors. However, sonographic observations from existing case reports of Krukenberg tumors commonly describe the tumors as roughly uniform solid masses with a strong echo, but lacking internal nodular structure (3,8). Sonographic observations in the present study revealed an encapsulated pedunculated solid and cystic mass, with multiple hyperechoic nodules in the solid portion, which was in accordance with the MRI and pathological results.…”

“…Krukenberg tumors account for 1–2% of all ovarian tumors (2) and the 5-year survival rate for a patient with a Krukenberg tumor ranges between 12 and 23.4% (3). The morbidity of pregnant patients with a Krukenberg tumor is even rarer and the survival rate is usually poor (2–5).…”

Three‐dimensional power Doppler with silhouette mode for diagnosis of malignant ovarian tumors

“…HDliveFlow with HDlive silhouette mode therefore facilitates the spatial visualization of blood vessels, demonstrating their dimensions and the relationships between them. Conventional two‐dimensional color Doppler reveals abundant vascularization, and in the case of Krukenberg tumor it will show the main vessel with a tree‐shaped structure penetrating from the periphery into the central part. However, elucidation of the precise pattern of intratumoral vasculature is easier to achieve using HDlive.…”