Clinical Images

Krukenberg Tumour Arising from Gastric Adenocarcinoma

Alae Chakir1,*, Tonguino RN1, Yousfi H1, Africha T2, Sinaa M3, Elkouti I1 and Lamsiah T1

1Department of Gastroenterology, Moulay Ismail Military Hospital- Meknes, Morocco
2Department of Radiology, Moulay Ismail Military Hospital- Meknes, Morocco
3Department Pathological Anatomy, Moulay Ismail Military Hospital- Meknes, Morocco

Received Date: 21/02/2023; Published Date: 27/04/2023

*Corresponding author: Alae Chakir, Gastroenterology Department at the Moulay Ismail Military Hospital- Meknes, Morocco

DOI: 10.46998/IJCMCR.2023.26.000626

Abstract

Krukenberg's tumors are rare tumors that always constitute a challenge for practitioners ovarian masses, hence the interest of a systematic gynecological examination in the presence of any digestive neoplasia and vice versa, a radiological and endoscopic digestive exploration is also deemed necessary in the presence of any ovarian tumor.

Keywords : Krukenberg; Gastric adenocarcinoma; Ovarian masse

We report the case of a 36-year-old woman with no medical and surgical history.

Admitted for progressive abdominal distension with early postprandial vomiting for 15 days the standard biological assessment revealed disturbances of the hepatic cytolysis assessment with slight cholestasis and anemia at 9g/dl, with an increase in the rate of CA 125.

An abdominal CT was performed showing antropyloric thickening with two bilateral ovarian masses and abundant ascites (Figure 1). We completed with an esogastroduodenal fibroscopy which showed an ulcerobudding process at the antral level making about 25 mm biopsied (Figure 2), the pelvic MRI made it possible to characterize the ovarian masses well (Figure 3) and the gastric biopsies confirm that it is a well differentiated and infiltrating gastric adenocarcinoma (Figure 1). the patient received a chemotherapy protocol based on 5FU-Cisplatine with Trastuzimab.Krukenberg's tumor is very rare and presents only 1 to 2% of ovarian tumors [1].  This tumor affects women during the period of genital activity. The average age reported in the literature is 40 years old, which is close to our patient who is 36 years old [2]. At present, the prognosis remains grim. The average survival reported in the literature is 12 months after the onset of diagnosis [2].

Figure 1 : CT image showing posterior gastric thickening with abundant ascite.

Figure 2 : Gastric adenocarcinoma: A- Macroscopic image; B- pathological microscopic picture.

Figure 3 : Axial slice in T1(a), T2(b) and T1 weighted sequence after Gado injection (c) of a pelvic MRI showing two bilateral ovarian masses which enhance after injection with abundant peritoneal effusion.

References

  1. Yakushiji M, Tazaki T, Nishimura H, Kato T. Krukenberg tumeurs de l'ovaire : une analyse clinicopathologique de 112 cas. Nihon Sanka Fujinka Gakkai Zasshi, 1987; 39(3): 479–485.
  2.  Bennaaboud I, Ghazli M, Kerroumi M. Tumeur de Krukenberg : à propos de 9 cas. Gynécol Obstet Biol Reprod, 2002; 31(4): 365–370.
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