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Early gastric cancer with Krukenberg tumor and review of cases of intramucosal gastric cancers with Krukenberg tumor
Authors:Naomi Kakushima  Toshiro Kamoshida  Shinji Hirai  Soichi Hotta  Tsuyoshi Hirayama  Jun Yamada  Kazumitsu Ueda  Munekatsu Sato  Minoru Okumura  Tatsuro Shimokama  Yuji Oka
Affiliation:(1) Department of Internal Medicine, Hitachi General Hospital, Ibaraki, Japan;(2) Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan;(3) Department of Surgery, Hitachi General Hospital, Ibaraki, Japan;(4) Department of Pathology, Hitachi General Hospital, Ibaraki, Japan
Abstract: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.
Keywords:early gastric cancer  Krukenberg tumor
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