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Incidental diagnosis of torsion of a Krukenberg tumor originating from sigmoid colon cancer
Gynecological Surgery volume 9, pages 193–194 (2012)
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A Krukenberg tumor refers to gastrointestinal cancer that metastasizes to the ovaries; this tumor was named after Krukenberg, who originally described this pathologic condition of the ovaries in 1896. The prognosis of this tumor is uniformly poor [1]. In the malignant state, the torsion of ovarian tumor is a rare condition because of the adhesions associated with malignant lesions. Two cases of torsion of Krukenberg tumors have been reported so far [2, 3].
A 46-year-old woman presented to the emergency department with abdominal pain. Abdominopelvic computed tomography showed a multicystic lesion with a diameter of 6.6 cm in the right ovary (Fig. 1). Pelviscopy showed a right ovarian mass that had twisted three times in a counterclockwise direction (Fig. 2). Right salpingo-oophorectomy was performed under pelviscopy. Strangely, however, the excised ovarian tissue was friable like caseous necrosis. After the right salpingo-oophorectomy was completed, the surgical specimen was sent to the department of pathology for obtaining a frozen section. Frozen-section analysis led to the diagnosis of adenocarcinoma; we performed exploratory laparotomy. Moreover, total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy, pelvic lymph node dissection, and low anterior resection of the colon were performed. The tumor was pathologically diagnosed as a metastatic adenocarcinoma of the colon. The patient was transferred to the department of oncology, and adjuvant chemotherapy (FOLFIIR#15) was administered.
References
Krukenberg F (1896) Ueber das fibrosarcoma ovarii mucocellulare (carcinomatoses). Arch Gynakol 50:287
Murakami S, Omi M, Yonemori A et al (2011) A case of emergency operation for pedicle torsion of ovarian tumor during bevacizumab therapy. Gan To Kagaku Ryoho 38(1):139–141
Alwyn JE, Zacharin RF (1963) Pregnancy complicated by torsion of a unilateral Krukenberg tumor. Aust N Z J Obstet Gynaecol 41:125–128
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Yi, S.W. Incidental diagnosis of torsion of a Krukenberg tumor originating from sigmoid colon cancer. Gynecol Surg 9, 193–194 (2012). https://doi.org/10.1007/s10397-011-0714-4
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DOI: https://doi.org/10.1007/s10397-011-0714-4