scholarly journals Krukenberg's Tumor as an Incidental Finding in a Full-Term Pregnancy: A Case Report

2020 ◽  
Author(s):  
Orlando Andres Nunez-Isaac ◽  
Felipe Mendoza-Rosado ◽  
Katheryn Lopez-Arjona ◽  
Alan Espinosa-Marron ◽  
Fernando Davila-Martinez
Keyword(s):  
Gastric Cancer ◽  
Pregnant Woman ◽  
Incidental Finding ◽  
Abdominal Cavity ◽  
Vena Cava ◽  
Krukenberg Tumor ◽  
Mri Findings ◽  
Signet Ring Cells ◽  
Uncommon Presentation ◽  
Signet Ring

BACKGROUND Krukenberg tumor is a rare metastatic tumor of the ovary with characteristic histopathological features known as signet-ring cells. It usually presents in women around 45 years of age, however, we present an uncommon case in a 38-year-old pregnant woman. We report this case because of the unusual findings, the uncommon presentation in this younger age bracket, its diagnostic challenge, and poor prognosis. CASE PRESENTATION We describe an unusual case of a young woman with a history of painful vaginal bleeding at 13 weeks of pregnancy and treated for abruptio placentae. In her routine prenatal visit at week 20 of pregnancy, she was found to have a uterine fundus greater than her gestational age and referred to the hospital to discard polyhydramnios. At her admission a pelvic ultrasound was performed with normal findings of a 25 weeks pregnancy, also showing bilateral enlarged ovaries with heterogeneous echogenicity. The MRI showed a left tumoral lesion with dimensions of 22.1 x 13.6 x 16.3 cm, with lobulated regular contours with displacement of peripheral structures and mild compression of the bladder, the left ureter, and the inferior vena cava. The lesion was heterogeneous with irregular borders. The patient was programmed for a cesarean section; during the operation, the abdominal cavity showed bilateral tumors compatible with MRI findings, the ovarian tumors were sent to pathology and the results showed poorly differentiated mucinous adenocarcinoma (WHO III) with extensive signet-ring cells, an indicative of Krukenberg tumor. CONCLUSION: The case presented is rare due to its presentation in a pregnant woman without identifiable risk factors for gastric cancer. The incidental finding suggests the pregnancy masked the clinical presentation of gastric cancer, and the rapid deterioration of the patient is consistent with the aggressiveness described in the literature. The limited descriptions of this neoplasm in our country and the torpid evolution of this case highlight the importance of further studies of this cancer in Mexico.

scholarly journals Krukenberg tumor as an incidental finding in a full-term pregnancy: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Felipe Mendoza-Rosado ◽  
Orlando Nunez-Isaac ◽  
Alan Espinosa-Marrón ◽  
Katheryn Lopez-Arjona ◽  
Fernando Davila-Martinez
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Incidental Finding ◽  
Abdominal Cavity ◽  
Vena Cava ◽  
World Health ◽  
Krukenberg Tumor ◽  
Signet Ring Cells ◽  
Uncommon Presentation ◽  
Signet Ring

Abstract Background Krukenberg tumor is a rare metastatic tumor of the ovary with histopathological features known as signet ring cells. It usually develops in women around 45 years of age. However, here we describe an uncommon case in a 38-year-old pregnant woman. We report this case due to our unusual findings, the uncommon presentation in this younger age bracket, its diagnostic challenge, and poor prognosis. Case presentation We describe a unique case of a young Mexican woman with a history of painful vaginal bleeding at 13 weeks of pregnancy and treated for abruptio placentae. In her routine prenatal visit at week 20 of pregnancy, she was found to have a uterine fundus exceeding the expected measure for her gestational age and was referred to the hospital to discard polyhydramnios. Upon admission, a pelvic ultrasound was performed displaying normal findings in a 25-week pregnancy, and also showing bilateral enlarged ovaries with heterogeneous echogenicity. Magnetic resonance imaging revealed a left tumoral lesion with dimensions of 22.1 × 13.6 × 16.3 cm presenting regular lobulated contours with displacement of peripheral structures and mild compression of the bladder, the left ureter, and the inferior vena cava. The lesion was heterogeneous with irregular borders. The patient was scheduled for a cesarean section; during the operation, the abdominal cavity showed bilateral tumors compatible with MRI findings. The ovarian tumors were sent to pathology, and the results showed poorly differentiated mucinous adenocarcinoma (World Health Organization grade III) with extensive signet ring cells, indicative of a Krukenberg tumor. Conclusion This case report describes an uncommon example of a young pregnant woman without identifiable risk factors for gastric cancer who manifested a Krukenberg tumor. This incidental finding suggests that pregnancy obscured the cancer’s clinical appearance. The rapid deterioration in the patient’s condition corresponds to what is described in the literature. The limited information regarding this neoplasm in Mexico and the torpid evolution of the case highlight the importance of conducting additional studies to generate therapeutic interventions aimed at increasing overall survival.

scholarly journals Mutations in Epigenetic Regulation Genes in Gastric Cancer

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4586
Author(s):  
Marina V. Nemtsova ◽  
Alexey I. Kalinkin ◽  
Ekaterina B. Kuznetsova ◽  
Irina V. Bure ◽  
Ekaterina A. Alekseeva ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Chromatin Remodeling ◽  
Epigenetic Regulation ◽  
Somatic Mutations ◽  
Distant Metastases ◽  
Clinical Markers ◽  
Signet Ring Cells ◽  
Mutational Profiling ◽  
Signet Ring ◽  
Epigenetic Processes

We have performed mutational profiling of 25 genes involved in epigenetic processes on 135 gastric cancer (GC) samples. In total, we identified 79 somatic mutations in 49/135 (36%) samples. The minority (n = 8) of mutations was identified in DNA methylation/demethylation genes, while the majority (n = 41), in histone modifier genes, among which mutations were most commonly found in KMT2D and KMT2C. Somatic mutations in KMT2D, KMT2C, ARID1A and CHD7 were mutually exclusive (p = 0.038). Mutations in ARID1A were associated with distant metastases (p = 0.03). The overall survival of patients in the group with metastases and in the group with tumors with signet ring cells was significantly reduced in the presence of mutations in epigenetic regulation genes (p = 0.036 and p = 0.041, respectively). Separately, somatic mutations in chromatin remodeling genes correlate with low survival rate of patients without distant metastasis (p = 0.045) and in the presence of signet ring cells (p = 0.0014). Our results suggest that mutations in epigenetic regulation genes may be valuable clinical markers and deserve further exploration in independent cohorts.

scholarly journals Polyserositis revealing a signet ring cells gastric adenocarcinoma in a 27 years old male patient: A case report.

2021 ◽  
Author(s):  
Zahid Talibi Alaoui ◽  
Salah Eddine Youbi ◽  
Fatima Ihbibane ◽  
Hind Rachidi ◽  
Fatima Ezzahra Hazmiri ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Emergency Department ◽  
Case Report ◽  
Clinical Improvement ◽  
Gastric Adenocarcinoma ◽  
Male Patient ◽  
Signet Ring Cells ◽  
Signet Ring

Abstract Gastric cancer remains one of the most common and deadly cancers worldwide, especially among old males. It is rare in the younger population (< 30 years old). We describe the case of a 27 years old male patient, presenting to the emergency department, with exsudative polyserositis, initially misdiagnosed and treated as a multifocal tuberculosis with no clinical improvement, later revealing a metastatic signet ring cells gastric adenocarcinoma.

scholarly journals Chemoradiotherapy Is Inferior to Chemotherapy Alone in Adjuvant Setting for Signet Ring Cell Containing Gastric Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Yue-Ting Zhu ◽  
Xin-Zu Chen ◽  
Ye Chen ◽  
Yu-Wen Zhou ◽  
Lian-Sha Tang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Signet Ring Cell ◽  
Adjuvant Chemoradiotherapy ◽  
Signet Ring Cells ◽  
D2 Gastrectomy ◽  
Vessel Invasion ◽  
Signet Ring ◽  
Ring Cell

BackgroundSignet ring cell containing gastric cancer (SRCGC) is a rare subtype of gastric cancer, and its adjuvant therapy is based on general gastric cancer. However, the effectiveness of radiotherapy for those SRCGC patients remains unknown.PurposeThe purpose of the study was to analyze whether the addition of radiotherapy to adjuvant chemotherapy (CT) can benefit survival in resected SRCGC patients.MethodsPatients with SRCGC, who underwent D2 gastrectomy followed by adjuvant chemotherapy or chemoradiotherapy (CRT), were retrospectively collected. According to the proportion of signet ring cells, patients were histologically classified as pure SRCGC (pSRCGC) containing 100% of signet ring cells, mixed SRCGC (mSRCGC) containing &gt;50% of signet ring cells, and contaminated SRCGC (cSRCGC) containing &lt;50% of signet ring cells. Among the 272 patients, 156 were treated by CT alone and 116 by CRT. The primary endpoint was 3-year overall survival rate (3-year OS rate).ResultsWith a median follow-up of 80.5 months, the 3-year OS rate was significantly higher in the CT group (70.5% vs. 58.6%, HR = 0.633, P = 0.017) compared with CRT group. Three independent characteristics were predictive of a poor overall survival: CRT treatment (P = 0.019), tumor size ≥5 cm (P &lt; 0.001), and the presence of vessel invasion (P = 0.009). Subgroup analyses showed CRT significantly impaired prognosis in SRCGC patients in the cSRCGC subset, as well as lesions located in lower-middle sites, subtotal gastrectomy, male, &lt;60 year, and no vessel invasion. Peritoneal was the most common recurrence site in SRCGC patients. The adverse events leukopenia and neutropenia were more common in the CRT group (P = 0.007).ConclusionsAdjuvant chemoradiotherapy was associated with poor survival compared with adjuvant chemotherapy in SRCGC patients with D2 gastrectomy.

scholarly journals Trimodal imaging to identify microscopic foci of signet ring cells in hereditary diffuse gastric cancer

Gut ◽  
2011 ◽  
Vol 60 (Suppl 1) ◽  
pp. A192-A193 ◽  
Author(s):  
Y. C. Lim ◽  
I. Debiram ◽  
M. O'Donovan ◽  
S. Richardson ◽  
S. Dwerryhouse ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Hereditary Diffuse Gastric Cancer ◽  
Diffuse Gastric Cancer ◽  
Signet Ring Cells ◽  
Signet Ring

scholarly journals Adrenal Crisis and Disseminated Intravascular Coagulation Associated With Disseminated Carcinomatosis of the Bone Marrow From Gastric Cancer

2021 ◽  
Author(s):  
Roland Y Lee ◽  
Elliott Goldberg ◽  
Jozef Malysz ◽  
Huili Li ◽  
Benjamin Shin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Bone Marrow ◽  
Disseminated Intravascular Coagulation ◽  
Adrenal Crisis ◽  
Appendicular Skeleton ◽  
Metastatic Adenocarcinoma ◽  
Signet Ring Cells ◽  
Intravascular Coagulation ◽  
Signet Ring ◽  
Diffuse Sclerosis

Abstract Gastric cancer is the third leading cause of cancer deaths worldwide. Disseminated carcinomatosis of bone marrow (DCBM) originating from gastric cancer is rare and associated with poor prognosis. We present the first reported case of gastric adenocarcinoma with DCBM leading to concomitant disseminated intravascular coagulation (DIC) and adrenal crisis refractory to treatment. Computerized tomography of the chest, abdomen and pelvis showed diffuse sclerosis of the axial and proximal appendicular skeleton, suggestive of metastatic disease. Bone marrow biopsy demonstrated infiltrative signet ring cells, consistent with metastatic adenocarcinoma from gastric primary. Laboratory tests showed severe anemia, thrombocytopenia, and coagulopathy, compatible with DIC.

scholarly journals Management of synchronous Krukenberg tumors from gastric cancer: A single-center experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15563-e15563
Author(s):  
Pengfei Yu ◽  
Ling Huang ◽  
Yian Du ◽  
Xiangdong Cheng
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Survival Benefit ◽  
Clinicopathological Characteristics ◽  
Signet Ring Cells ◽  
Ovarian Metastases ◽  
Single Center Experience ◽  
Signet Ring ◽  
Krukenberg Tumors ◽  
Gastric Cancer Patients

e15563 Background: Whether metastasectomy improves prognosis of gastric cancer patients with ovarian metastases (Krukenberg tumors) is not clear. In this study, we examined the survival benefit of metastasectomy combined with chemotherapy for treatment of synchronous Krukenberg tumors from gastric cancer and identified the prognostic factors. Methods: The subjects of this study were patients diagnosed as synchronous Krukenberg tumors of gastric origin in the period between December 2004 and December 2015. Patients were classified in accordance with treatment modality: metastasectomy group (metastasectomy combined with chemotherapy) and non-metastasectomy group (chemotherapy alone). Clinicopathological characteristics together with treatment records were investigated in detail and their relationship with survival outcomes was examined. Results: Out of a total of 103 patients, 54 (52.4%) underwent metastasectomy of Krukenberg tumors while 49 (47.6%) patients had chemotherapy alone. Overall survival (OS) in the metastasectomy group was significantly longer than that in the non-metastasectomy group (18.9 months vs. 12.4 months, respectively; P < 0.001). Metastasectomy (hazard ratio [HR] 0.486; 95% confidence interval [CI] 0.323–0.729; P < 0.001), signet ring cells (HR 1.938; 95% CI 1.182–3.175; P = 0.009), peritoneal carcinomatosis (HR 1.934; 95% CI 1.230–3.049; P = 0.004), expression of estrogen receptor-β (ER-β) (HR 0.404; 95% CI 0.251–0.648; P < 0.001), and progesterone receptor (PR) (HR 0.496; 95% CI 0.301–0.817; P < 0.001) were independent predictors of OS. Conclusions: Metastasectomy combined with chemotherapy showed an association with survival benefit in patients with synchronous Krukenberg tumors from gastric cancer. Metastasectomy, expression of ER-β and PR, peritoneal carcinomatosis, and signet ring cells were independent predictors of survival. Further prospective studies are warranted.

SIGNET-RING CELLS IN ADVANCED GASTRIC CANCER A Clinical, Pathological and Histochemical Study

2009 ◽  
Vol 95A (1-6) ◽  
pp. 225-231
Author(s):  
DONATELLA SANTINI ◽  
FLORIANO BAZZOCCHI ◽  
GUIDO MAZZOLENI ◽  
MONICA RICCI ◽  
GIULIANO VITI ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Histochemical Study ◽  
Signet Ring Cells ◽  
Signet Ring
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