Krukenberg tumor presenting as back pain and a positive urine pregnancy test: a case report and literature review.

A Krukenberg tumor is a rare and potentially deadly cause of elevated serum ß-hCG as part of a paraneoplastic syndrome. This study aims to describe the unusual case of a 36-year-old woman that presented to the Emergency Department (ED) with back pain and a positive urine pregnancy test. Assessment revealed no intrauterine pregnancy and a small left ovarian cyst. Further investigation showed moderately differentiated gastric adenocarcinoma with distant metastases to the spine. The patient died less than 3 months after her first presentation to the ED. Paraneoplastic syndrome, albeit rare, should be considered in the differential diagnosis of elevated ß-hCG due to the high mortality associated with Krukenberg tumors.

[Krukenberg tumor during pregnancy with maternal and fetal virilization: a difficult diagnosis. A case report]. / Tumeur de Krukenberg associée à la grossesse avec virilisation maternelle et foetale: un diagnostic difficile. A propos d'un cas.

We present a case of maternal and fetal virilization caused by an androgen-secreting ovarian tumor. Biopsy at caesarean section was required to determine the etiology (Krukenberg tumor) and orient diagnosis to a primary cancer (gastric adenocarcinoma).

Serum and tissue measurements of CA72-4 in ovarian cancer patients.

Serum levels of cancer-associated antigen 72-4 (CA72-4) (tumor-associated glycoprotein 72; TAG-72) from 106 patients with primary ovarian cancer were measured by an immunoradiometric assay employing the monoclonal antibodies (MAbs) B72.3 and CC49. Immunohistochemical localization of TAG-72 was also investigated using immunoperoxidase methodology in conjunction with both light and electron microscopy. In using a cutoff value of 4.0 U/ml for the serum assay, sensitivity of all primary ovarian carcinomas was 63.2% (67.6% of mucinous cystadenocarcinomas and 66.7% of serous cystadenocarcinomas), while specificity of benign ovarian tumors was 91.1%. Diagnostic characteristics of CA125 and CA72-4 have been demonstrated by receiver-operating-characteristics analysis. Although CA125 expressed a remarkable diagnostic efficiency with serous cystadenocarcinoma, it was less efficient with mucinous cystadenocarcinoma. CA72-4, however, was highly detectable for any histological type of ovarian cancer. Immunohistochemical staining with MAbs B72.3 and CC49 in the cytoplasm was stronger than that in the cell membrane in tissues from mucinous cystadenocarcinomas. Also, histological localization of TAG-72 in the microvilli and apical cytoplasmic membrane was demonstrated by electron microscopy using MAb B72.3 and samples of seromucinous cystadenocarcinoma (mixed type). Consequently, TAG-72 was useful for the detection of ovarian carcinoma, especially for monitoring mucinous cystadenocarcinoma, and it is localized in the microvilli and apical cytoplasmic membrane of cystadenocarcinoma cells.

[Krukenberg's tumor. Apropos of a case. Review of the literature]. / Tumeur de Krukenberg. A propos d'un cas. Revue de la littérature.

A case is reported of krükenberg's tumor, this rare lesion characterized by the constant presence of typical signet ring cells being an ovarian metastasis from a general digestive cancer. The primary neoplasm is often overlooked while the ovarian tumor is already large and bilateral. In a pregnant patient with this lesion virilization of mother and child may occur, this endocrine activity being poorly documented and the subject of a literature review. The pathogenicity of this tumor is still unknown. Endocrine investigations should be enlarged in the fairly rare cases when diagnosis is suspected prior to ovarian excision. Treatment is currently surgical but survival is little improved. Other therapy is only poorly effective.

[A case of Krukenberg tumor associated with elevation in blood testosterone].

One case of Krukenberg tumor associated with elevation in blood testosterone levels was reported. The patient was a 31-year-old woman. She visited the outpatient service of our hospital with the chief complaint of uterine bleeding and infertility. She was diagnosed to have an anovulatory cycle associated with elevation in blood testosterone levels. However, after an examination at our hospital, a tumor of the left ovary was pointed out and she underwent bilateral ovariectomy. Postoperatively, tarry stool was passed, for which she received an examination at the department of internal medicine. Roentgenography of the stomach and examination by a gastric camera revealed undifferentiated carcinoma of Borrmann's type III in the greater curvature of the angular area. This lesion was diagnosed to be Krukenberg's tumor and a gastrectomy was performed. On the other hand, the blood testosterone level which had shown elevation before resection of the ovaries was restored to the normal range after the operation. Various reports have been published concerning the endocrinological activity of this tumor. It remains to be elucidated whether it is due to metastasis of the carcinoma or if it originates from other ovarian parenchyma. However, it has been reported that elevation in endocrinological activity is apt to occur when the tumor originates from the digestive tract.