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

Abstract

Background: Krukenberg tumor is a rare metastatic ovarian cancer, usually solid and mostly detected bilaterally. Common primary sites of the tumor are the gastrointestinal (GI) tract and the breast. Case Presentation: A 42-year old female patient, who was previously diagnosed with a cyst in the right ovary, reported severe pelvic pain, constipation, and rectal bleeding for the last two months. Pre-operative serum CA-125 level was normal. Ultrasound and Computed Tomography (CT) revealed the presence of a mass of cystic and solid elements in the right ovary. The intraoperative detection of a mass in the rectosigmoid led to right oophorectomy with fallopian tube excision, Hartmann's procedure and appendectomy. Histological examination revealed mucinous cystadenocarcinoma of the ovary, while sites of moderately differentiated adenocarcinoma were detected in the colon specimen. Conclusion: This occurrence of unilateral Krukenberg tumor with synchronous colonic adenocarcinoma is quite rare. The rectosigmoid as a primary site has been scarcely reported in the literature.