Sarita Kumari*, Sunesh Kumar, Jyoti Meena and Seema Singhal
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, IndiaFulltext PDF
Krukenberg tumor tends to occur in a younger age group and common presenting symptoms are abdominal pain and distension. We describe a case of Krukenberg tumor where amenorrhea was the only presenting symptom and the primary tumor was identified four months after resection of metastatic ovarian masses. A 20 year old female presented with amenorrhea of three months. On examination she had bilateral adnexal mass. Tumor markers were normal. Esophagogastroduodenoscopy and proctosigmoidoscopy revealed healthy mucosa. MRI showed bilateral 13 cm × 12 cm × 6 cm and 12 cm × 10 cm × 6 cm hypointense masses likely dysgerminoma. Intraoperative there was bilateral solid cystic ovarian mass and frozen section was s/o metastatic adenocarcinoma with signet ring cell differentiation. On final histopathology tumor cells were immunopositive for pan-cytokeratin (diffuse) and CK20 (focal). Postoperative PET CT done to identify primary was normal. After four months repeat PET CT was done which revealed uptake in stomach and mesenteric nodes. Repeat upper GI endoscopy detected an ulcer in posterior wall of stomach and biopsy showed signet ring cell adenocarcinoma. She received palliative chemotherapy with capecitabine and oxaliplatin for six cycles. Progressive disease was detected on follow up and she was started on second line chemotherapy with carboplatin and paclitaxel.
Kumari S, Kumar S, Meena J, Singhal S. Krukenberg Tumour with Occult Gastric Primary in a 20 Year Old Presenting with Amenorrhea as Initial Symptom. Clin Oncol. 2020; 5: 1745.