Krukenberg tumor in a young woman: A rare presentation

Abstract

Krukenberg tumors mostly occur after 40 years. Metastatic ovarian tumors in young age are very rare and reported to be 2% of all the cases. Thirty percent of all ovarian neoplasms occurring during childhood and adolescence are malignant. A 25-year-old woman, parity-2, presented with abdominal distension, pain in abdomen and amenorrhea. On examination, 18 weeks lump was palpable, firm to hard in consistency, non-tender and mobile. On ultrasonography bilateral ovarian tumors were reported, without any peritoneal free fluid. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Microscopic examination revealed signet ring cells with glandular differentiation, diffusely invading the ovarian parenchyma. Tumor cells exhibited strong, diffuse immunopositivity for CEA with focal strong immunopositivity for CK7 and CK20 and immunonegativity for SATB2. Diagnosis of Krukenberg tumor was made. Endoscopic biopsy confirmed the diagnosis of adenocarcinoma stomach. This case is reported because of its rarity in younger age group.

Unilateral krukenberg tumor can originate from rectosigmoid adenocarcinoma: a case report with normal pre-operative serum CA-125 level

“…Our patient was 42 years old, confirming the fact that the disease is usually present within an average range of 40-46 years old. 3 Half of the patients present ascites as a syptom. 1 Its absence from our case is theoretically considered to be a good prognostic factor, as its presence usually reveals peritoneal infiltration.…”

“…1,5,6 Moreover, KT is mainly attributed to carcinomas of the GI tract (appendix, liver, pancreas, biliary tract and gallbladder) and rarely to that of the breast. 1,2,3,7,8 We report a rare occurrence of rectosigmoid carcinoma as the primary site of a unilateral KT metastasis (right ovary) with normal levels of CA-125. Specific significance with respect to prognosis and decision-making is underscored.…”

“…Initially, it was difficult to determine the primary site of the neoplasm, by differential diagnosis, even though the immunohistochemical findings indicated clearly the large intestine as the primary site. 3 Subsequently, the patient was admitted for adjuvant chemotherapy right after the surgery. She has been undergoing 4 cycles of chemotherapy with capecitabine/irinotecan combination regimen.…”

“…Krukenberg Tumor (KT) is an infrequent metastatic tumor of the ovary, accounting for 1% to 2% of all ovarian tumors. [1][2][3] Being a subject of debate for over a century, the KT is mainly considered as a metastatic neoplasm. 1,4 Despite the fact that two recent studies report the colorectum as the most frequent primary site, the stomach is generally considered as the most common primary site of the disease (70%).…”

Krukenberg Tumor in Adolescent: A Rare Occurrence

“…1 To differentiate primary ovarian mucinous carcinoma from metastatic carcinoma is that primary is usually unilateral tumor and absence of signet ring cells. 3 Management must involve finding and treating the primary tumor. Multimodality approach is ideal.…”