Krukenberg tumour

Case contributed by Western General Colorectal

Presentation

Chronic cough and worsening shortness of breath. Expanding abdominopelvic mass over the last 2 months.

Patient Data

Age: 55
Gender: Female
Modality: Photo

Huge abdominal mass clearly visible on examination.

Blood results

  • hypochromic microcytic anaemia
  • CEA: 126 (normal 0-5)
  • CA 125: 51 (normal 0-35)
Modality: X-ray

Multiple focal nodular densities throughout both lungs. In the context of suspected malignancy, highly suspicious for metastatic disease.

Modality: Ultrasound

Large hypoechoic heterogeneous multi-lobulated mass within the abdomen. Not hypervascular.

Modality: CT

CT confirmed the US finding of a large lobulated intra-abdominal mass and confirmed liver and lung metastases.

Surgery 1 month later:

  • clinical deterioration with pain
  • worsening anaemia
  • decompensation of respiratory function

Intra-operative photos

Modality: Photo

Intraoperative photography demonstrating a large tumour arising from the ovary and a much smaller primary colonic neoplasm.

CT/intra-operative correlation

Modality: Annotated image

The large ovarian mass has the expected lobulated pattern. The thickened caecal wall seen on the CT is identified intra-operatively.

Case Discussion

Krukenberg tumour (carcinoma mucocellulare)

  • metastatic ovarian adenocarcinoma from different primary tumour sites
  • gastric carcinoma is the commonest primary tumour (~50% of Krukenberg tumours)
  • T4 colonic adenocarcinoma have potential for transcoelomic spread to the ovaries
  • discrimination between primary and metastatic ovarian tumours is important

Learning points

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Case Information

rID: 46068
Case created: 20th Jun 2016
Last edited: 23rd Sep 2016
Inclusion in quiz mode: Included
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