Early gastric cancer with Krukenberg tumor and review of cases of intramucosal gastric cancers with Krukenberg tumor.
A 47-year-old woman was admitted because of hypermenorrhea. Transvaginal ultrasonography revealed an ovarian tumor and myoma uteri, and total hysterectomy with bilateral salpingo-oophorectomy was performed. Histology revealed signet-ring cell carcinoma in the right ovary. In order to find out the primary site of this tumor, gastroendoscopy was performed after the operation, and showed a IIc lesion in the lower body of the stomach; biopsy specimens showed signet-ring cell carcinoma similar to that in the right ovary. Total gastrectomy revealed that the lesion was an early gastric cancer confined to the mucosa, but there was lymphatic invasion slightly beneath the muscularis mucosa, with regional lymph node metastasis. In the light of a review of the seven cases of early gastric cancer with Krukenberg tumor previously reported, lymphatic metastasis seemed to be the most likely pathway of ovarian metastasis in early gastric cancers.
Kakushima
Naomi
N
Department of Internal Medicine, Hitachi General Hospital, Ibaraki, Japan.
Kamoshida
Toshiro
T
Hirai
Shinji
S
Hotta
Soichi
S
Hirayama
Tsuyoshi
T
Yamada
Jun
J
Ueda
Kazumitsu
K
Sato
Munekatsu
M
Okumura
Minoru
M
Shimokama
Tatsuro
T
Oka
Yuji
Y
D005260:Female; D006801:Humans; D007725:Krukenberg Tumor / Q000556:secondary*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000556:secondary*; D013274:Stomach Neoplasms / Q000473:pathology*