Ovarian metastases of intestinal-type gastric carcinoma: A clinicopathologic study of 4 cases with contrasting features to those of the Krukenberg tumor.
ABSTRACT Ovarian metastases of intestinal-type gastric adenocarcinomas are rare, and information on them is very limited compared with that on signet-ring cell carcinomas that result in the Krukenberg tumor. Four cases are reported herein. The patients averaged 55 years of age. In 3 patients, the ovarian metastases were identified several to 21 months after the diagnosis of the gastric primary, and the tumors were synchronous in the fourth. Two tumors were bilateral, 1 unilateral, and for 1, the laterality was unknown. The ovarian tumors were characteristically solid and cystic, with multinodular growth in 2. In 2 cases, the ovarian tumors had a pseudoendometrioid morphology with tubulo-glandular, cribriform, and papillary patterns; they also had focal trabecular and insular patterns. Prominent necrosis was present, including segmental and intraluminal "dirty" necrosis. In the other 2 cases, the ovarian tumors had a mucinous appearance, 1 being dominantly cystic with occasional goblet cells and the other with prominent foveolar-type cells. Nuclei ranged from deceptively bland to highly atypical. Surface implants were identified in 2 cases. Two ovarian tumors examined expressed cytokeratin 7 and 20 but not estrogen receptor. Three patients with follow-up information all died within 1 year of the ovarian metastases. Although information is limited, our results suggest that metastatic spread to the ovary by intestinal-type gastric adenocarcinoma is usually seen in patients older than those with Krukenberg tumors, with a known history of gastric carcinoma, and with concomitant widespread disease. Involvement of the ovary by intestinal-type gastric carcinoma produces a microscopic picture distinctly different from that of a Krukenberg tumor. These metastatic intestinal-type tumors may be confused with metastases from other gastrointestinal sites that are more frequently the cause of pseudoendometrioid or mucinous metastases, and like such tumors may be confused with primary ovarian endometrioid and mucinous neoplasms.
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ABSTRACT: Gastric cancer, one of the most common cancers in the world, rarely metastasizes to the ovaries. Ovarian metastases of gastric signet ring cell cancer (SRCC) are referred to as Krukenberg tumors and account for 1-2% of all ovarian cancers. Here, we analyze the characteristics, treatment, and prognosis of patients with Krukenberg tumors. We retrospectively analyzed the demographic characteristics, treatment modalities, progression-free survival (PFS), and overall survival (OS) of patients who were diagnosed with Krukenberg tumors of gastric cancer origin and who underwent treatment and follow-up between January 2005 and January 2012 in the Ankara Oncology Education and Research Hospital. Among 1755 patients diagnosed with gastric cancer between January 2005 and January 2012, eight patients (0.45%) with histopathologically identified Krukenberg tumors were enrolled. The median age of the eight patients was 42.2 years (range, 32-69 years). Two (25%) of the patients were stage 3A, two (25%) were stage 3C, and four (50%) were stage 4 at the time of diagnosis. The median PFS was 13.2 months (1-25 months), the median OS after the original diagnosis was 16.7 months (1-41 months), and the median OS after ovarian metastasis was 3.6 months (1-10 months). Krukenberg tumors were seen particularly in young patients and more frequently during the premenopausal period. The prognosis was poor. When only the ovaries were affected, metastasectomy prolonged the survival time.Contemporary Oncology / Wspólczesna Onkologia 12/2013; 17(6):515-9. DOI:10.5114/wo.2013.37542 · 0.22 Impact FactorThis article is viewable in ResearchGate's enriched formatRG Format enables you to read in context with side-by-side figures, citations, and feedback from experts in your field.
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ABSTRACT: Cesitli nedenlerle tam olarak kestirilemeyen metastatik over tümörlerinin insidansi, cografi bölgelere göre de degiskenlik göstermekte olup, bir over tümörünün metastatik tabiatindan emin olmak için hem klinisyen hem de patologun, over tümörlerinin metastatik olma ve primer over tümörünü taklit etme ihtimalinin yüksekliginden siddetle haberdar olmasi, klinisyenin, patologun sözüne kulak vererek primer oldu¤unu zannedip malignligi nedeniyle acele edip kemoterapiye baslamadan patologun talebini göz önüne alarak gerektiginde over disi bir primer tümörün varligi konusunda tekrar ciddi bir klinik arastirma yapmasi, patologun da makroskopik, mikroskopik incelemelerini tekrarlayip gereginde yeni parçalar alarak, immünhistokimyasal yöntemleri çok dikkatli ve düdünceli bir dekilde kullanarak dogru taniyi yakalamaya çalismasi gerekir. Bu bölümü kaleme alirken amacimiz overin metastatik tümörlerini detayi ile anlatmak degil, kavram degiflikligi ve yeni gelisen bilgiler nedeniyle kitabin editörü tarafindan talebedilmis olan "Psödomiksoma peritonei" ve "Krukenberg tümörleri" konularindaki bilgilerimizi güncellemektir.Jinekolojik Onkoloji, Edited by Ali Ayhan, 01/2013: chapter 115; Gunes Kitabevi, Ankara., ISBN: 9789752774490
Edited by Ali AYHAN, 01/2013; Gunes Kitabevi. Ankara., ISBN: 9789752774490