Definition

A Krukenberg tumor is the name given to tumors of the ovaries. Although they may appear to be a primary tumor of the ovary, are always a metastasis (i.e. a secondary tumor) which has spread from a malignant tumour in another site. Krukenberg tumors are often found in both ovaries. Microscopically, they is characterized by appearance of mucin-secreting signet-ring cells in the tissue of the ovary; when the primary tumor is discovered, the same signet-ring cells will be found. See the article about cancer for the main article about malignant tumors. ... Human female internal reproductive anatomy Ovaries are a part of a female organism that produces eggs. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ... Mucins are a family of large, heavily glycosylated proteins. ... A signet is a seal used to authenticate a document, typically by leaving an impression in sealing wax. ...

Historical

The Krukenberg tumor is named after Friedrich Ernst Krukenberg (1871-1946), a German doctor who first described them as "fibrosarcoma ovarii mucocellulare carcinomatodes". A short of biography of Krukenberg can be found at WhoNamedIt.com

Etiology and Incidence

Metastatic cancer of the ovary accounts for only about 5% of ovarian cancer; in the remainder, the ovary is ther primary cancer site. Krukenberg tumors are the third most common metastatic ovarian cancer (after epithelial and germ-cell tumors) and make up 14% of these cancers. Unlike some forms of cancer, there is no racial bias. Krukenberg tumors are most commonly seen in middle-aged and elderly females, around or following the menopause. Menopause (also known as the Change of life or climacteric) is a stage of the human female reproductive cycle that occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down. ...

Symptoms

Patients with Krukenberg tumor often come to the attention of their doctor when they present complaining of abdominal or pelvic pain, bloatedness, vaginal bleeding, a change in their menstrual habit or pain during intercourse. These symptoms are non-specific (i.e. they point to a range of problems other than cancer) and a diagnosis can only be made following Computed Tomography (CT) scans, laparotomy and/or a biopsy of the ovary. CT apparatus in a hospital Computed tomography (CT), also known as computed axial tomography or computer-assisted tomography (CAT) and body section roentgenography, is a medical imaging method employing tomography where digital processing is used to generate a three-dimensional image of the internals of an object from a large... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Pathogenesis

There is some debate over the exact mechanism of metastasis of the tumour cells from the stomach, appendix or colon to the ovaries; classically it was thought that direct seeding across the abdominal cavity accounted for the spread of this tumor, but recently some researchers have suggested that lymphatic (i.e. through the lymph nodes), or haematogenous (i.e. through the blood) spread is more likely, as most of these tumours are found on the inside of the ovaries. Proponents of this theory cite the fact that metastases are never found in the omentum (the fatty apron which lies envelops the organs of the abdomen and lies between the stomach and ovaries), and that the tumor cells are found within the ovary and not growing inwards. In higher vertebrates, the peritoneum is the membrane that forms the lining of the abdominal cavity - it covers most of the intra-abdominal organs. ...

Although a Krukenberg tumor is most commonly a metastasis from a gastric cancer (usually an adenocarcinoma), this is not always the case. Other tumours of the gastrointestinal tract (including, significantly, colon cancer) have been known to cause Krukenberg tumours, and recent case-reports of Krukenberg tumors originating from tumors of the tip of the appendix have appeared in the medical literature. In medicine, stomach cancer (also called gastric cancer) can develop in any part of the stomach and may spread throughout the stomach and to other organs. ... In medicine, carcinoma is any cancer that arises from epithelial cells. ... The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and expels the remaining waste. ... Diagram of the stomach, colon, and rectum Colorectal cancer includes cancerous growths in the colon, rectum and appendix. ...

Treatment and Prognosis

Since the Krukenberg tumor is a secondary (metastatic) tumor, management of the tumor must involve finding and treating the primary cancer. In general, most cases of Krukenberg tumor have a poor prognosis and radical operation such as removal of the ovaries (and the colon or appendix if involved) can improve survival only in cases of solitary ovarian metastasis or local extended disease (i.e. the lesion is located only in the pelvis). Cancer chemotherapy and radiotherapy before surgery may be used to shrink the tumor and facilitate its removal. Chemotherapy is the use of chemical substances to treat disease. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...