Krukenberg Tumor and Virilization in Pregnancy: Report of a Case and Review of the Literature
DOI:
https://doi.org/10.32635/2176-9745.RBC.1999v45n3.2783Keywords:
Ovary Neoplasm, Krukenberg Tumor, Signet Ring Cells, Gastraintestinal CâncerAbstract
Krukenberg tumor (KT) is a rare descase characterized by a secondary ovarian neoplasm to a gastrointestinal tract tumor, it is frequently bilateral, voluminous and assymptomatic. It corresponds from 1% to 5% of all ovarians tumours that affect women in their fourth decade. Histologically it is like signet ring cells with reactive and intense non neoplasic stromal proliferation. Few cases of functional KT are related, and association with virilization during pregnancy is rare. The authors report one case of a female patient, 35 years old, in the second quater of pregnancy, with hirsurtism, acne, masculine voice and systemic arterial hypertension. Prenatal ultrasonography showed a voluminous tumor on the left ovary. She was then submited to cesarian section and the newborn male was normal. A laparotomy to take off the tumor on the left ovary revealed peritoneal carcinomatous, ascites, liver metastasis and lesion on the small gastric curvature. Histologic test of the ovarian tumor and gastric biopys showed adenocarcinoma with little differenciated signe ring cells. Chemotherapy and radiotherapy had been done, with no answer. The patient died eight months after the diagnosis.
Downloads
References
WONG, P.C.; FERENCZY,A.;FAN,L.D.; MCCAUGHEY, E. - Krukenberg tumores of the ovary: ultrastructural, histochemical and immunohistochemical - study of 15 cases. Câncer, 57: 751-760, 1986. DOI: https://doi.org/10.1002/1097-0142(19860215)57:4<751::AID-CNCR2820570412>3.0.CO;2-G
GILLILAND, R.; GILL, RJ. – Incidence and prognosis of Krukenberg tumor in Northern Ireland.firy^Mrg, 79: 1364-1366, 1992. DOI: https://doi.org/10.1002/bjs.1800791241
HOLTZ, F.; HART, W.R. – Krukenberg tumores of the ovary. Câncer, 50: 2438- 2447, 1982. DOI: https://doi.org/10.1002/1097-0142(19821201)50:11<2438::AID-CNCR2820501132>3.0.CO;2-X
BORTELHO, C.C.R.; GONÇALVES, W.J.; HAIDAR, M.A.; STÁVALE, N.J.; BARACAT, E.C.; LIMA, G.R. - Considerações a respeito do tumor de Krukenberg. Ginecol Obstet, IV: 284-292, 1995.
LORIMIER, G.; REIHNER, B.; RIVE, C.; CRONIER, P; TALHA, A.; GUNTZ, M.; Ovarian metastasis of digestive cancers: diagnosis and manangement. J Chir, 125: 699-703, 1988.
CACCI AGUERRA, S.; MIANO, A.E.; Dl BENEDETTO, A.; VASQUEZ, E.; MAGRO, G.; FRAGGETTA, F. – Gastric carcinoma with ovarian metastases in na adolescent. Pediatr Surg Int, 14:98-99, 1998. DOI: https://doi.org/10.1007/s003830050449
SCULLY, R.; RICHARDSON, G.S. - Luteinization of the stroma of metastatic câncer involving the ovary and its endo-crine significance. Câncer, 14: 827-840, 1961. DOI: https://doi.org/10.1002/1097-0142(199007/08)14:4<827::AID-CNCR2820140420>3.0.CO;2-K
SPADONI, L.R.; LINDBERG, M.C.; MOTTET, N.K.; HERRMANN, W.L. - Virilização coexisting with Krukenberg tumor durint pregnancy. Am J Obst & Gynec, 92: 981-991, 1965. DOI: https://doi.org/10.1016/0002-9378(65)90732-5
VAUTHIER, B.D.; VANNA, L.Y.K.; SEBAGH, E.; LEVEBVRE, G.; DARBOIS, Y. - Krukenberg tumor during pregnancy with maternal and fetal virilization: a difficult diagnosis. J Gynecol Obstet Biol Reprod (Paris), 26:831-833, 1997.
ARNEDILLO, M.A.; RODRIGUES, G.M.C.; PUENTE, M.; GARCÍA, PJ. - Dyspnea as the only symptom in a Krukenberg tumor. An Med Interna, 13:564-565, 1996.
CHOU, M.M.; HO, E.S.; LIN, N.F.; LEE, Y.H. - Color doppler sonografic appearance of a Krukenberg tumor in pregnancy. Ultrasound Obstet Gynecol, 11:459-460, 1998. DOI: https://doi.org/10.1046/j.1469-0705.1998.11060459.x
CHO, J.Y.; SEONG, C.K.; KIM, S.H. - Krukenberg tumor findings at color and power Doppler US: correlation with find ings at CT, MR imaging, and pathology: case reports. Acta Radiol, 39:327-329, 1998. DOI: https://doi.org/10.1080/02841859809172204
KIM, S.H.; KIM, W.H.; PARK, K.J.; LEE, J.K.; KIM, J.S. - CT and MR findings of Krukenberg tumors: comparation with primary ovarian tumors. J Comput Assist Tomogr, 20:393-398, 1996. DOI: https://doi.org/10.1097/00004728-199605000-00013
TAMUSSINO, K.; SCHÔLL, W.; REICH, O.; WINTER, R. - Gastric carcinoma presenting as a Krukenberg tumor in the 24th week of gestation. Eur J Obstet Gynecol ReprodBiol, 62:251-252, 1995. DOI: https://doi.org/10.1016/0301-2115(95)02179-B
DE PALMA, P; WRONSKY, M.; BIFERNINO, V.; BOVANI, L - Krukenberg tumor in pregnancy with virilization: a case report. Eur J Gynaecol Oncol, 16:59-64, 1995.
WOODRUEF, J.D.; MURPHY, Y.S.; BHASKAR, J.N.; BORDBAR, E; TSENG, S.S. -Metastatic ovarian tumors. Am J Obstet, 202-209, 1970. DOI: https://doi.org/10.1016/0002-9378(70)90586-7
FOREST, M.G.; ORGIAZZI, J.; TRANCHANT, D.; MORNEX, R.; BERTRAND, J. - Approach to the mechanism of androgen overproduction in a case of Krukenberg tumor responsible for viril-
ization during pregnancy. JCE & M, 47: 428-734, 1978. DOI: https://doi.org/10.1210/jcem-47-2-428
TURUNEN, A. - Hormonal secretion of Krukenberg tumours. Acta endocrinol, 20: 50-56, 1955. DOI: https://doi.org/10.1530/acta.0.0200050
BULLON, A.; ARSENEAU, J.; PRAT, J.; YOUNG, R.H.; SCULLY, R.E. – Tubular Krukenberg tumor: a problem in histopathologic diagnosis. Am J Surg Pathol, 5: 225, 1981. DOI: https://doi.org/10.1097/00000478-198104000-00002
MACKEY, J.R.; HUGH, J.; SMYLIE, M. - Krukenberg tumor complicated by pregnancy. Gynecol Oncol, 61:153-5, 1996. DOI: https://doi.org/10.1006/gyno.1996.0116
KLEIN, H.O. - Long-term results wifh FA-MTX in advanced gastric câncer. Anticancer Rei, 9:1025, 1989.
HAIM, L. - Etoposide, doxorubicin, cisplatin (EAP 2) chemotherapy for advanced gastric adenocarcinoma. Oncology, 51:102-107, 1994. DOI: https://doi.org/10.1159/000227319
