Ovarian Mass Leading to the Diagnosis of Krukenberg Tumour: A Case Report | Chapter 2 | Medical Science: Updates and Prospects Vol. 3

 

A Krukenberg tumour is a distinct metastatic ovarian carcinoma, a secondary ovarian malignancy arising from a distant primary site. They often show nonspecific gastrointestinal symptoms, which lead to a delayed diagnosis and a poor prognosis.

 

This case report exemplifies the challenges associated with diagnostic delays of Krukenberg tumours, especially in distinguishing metastatic ovarian tumours from primary ovarian cancer, and the limited treatment options available in the advanced stages of the disease, which can affect patients' prognosis.

 

Histopathological analysis revealed diffusely invasive growing cancerous tissue with granular and diffuse single distribution in which numerous tumour cells had a signet–ring appearance indicative of a Krukenberg tumour from the stomach.  Despite postoperative recovery and subsequent admission for treatment, the patient encountered recurrent obstruction and ultimately succumbed.

 

This report present the case of a 29-year-old woman of African Descent, Gravida 1 para 1, who presented to the accident and emergency room with persistent abdominal pain, distension, and vomiting. Erect Abdominal X-ray demonstrated dilated bowel loops. Transabdominal ultrasonography revealed a complex adnexal mass measuring approximately 13.9 × 8.5 cm, involving the ovary and fallopian tube, extending into the cul-de-sac and Morrison’s pouch. A subsequent CT imaging showed Heterogeneous intraperitoneal pelvic tumours measuring 12.0 × 11.4 × 8.7 cm, associated with ascites and evidence of intestinal obstruction. Free fluid was also noted throughout the peritoneal cavity. The patient underwent an exploratory laparotomy, which identified friable ovarian masses measuring 8 × 10 cm on the left and 10 × 14 cm on the right, along with a 10 × 4 cm omental mass. Additional metastatic deposits were observed on the fallopian tubes, transverse colon, and peritoneum. All grossly visible tumours were surgically excised.

 

This case highlights a rare presentation of bilateral metastatic Krukenberg tumours from primary gastric adenocarcinoma in a young woman. It underscores the diagnostic challenges posed by nonspecific gastrointestinal symptoms and emphasises the importance of early, accurate diagnosis using imaging, endoscopy, histopathology, and immunohistochemistry. Multidisciplinary management is essential to guide surgical, oncologic, and palliative care, optimising outcomes and quality of life even in advanced-stage disease.

 

 

Author(s) Details

Amanda Gray
Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana.

 

Jeniesa Klass
Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana.

 

Malika Bacchus
Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana.

 

Owens Ogbeiwi
Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana.

 

Nirvani Goberdhan
Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana.

 

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