A case of virilization induced by a Krukenberg tumor from gastric cancer
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Open Access
Case report
A case of virilization induced by a Krukenberg tumor from gastric cancer Matthias Hornung1, Peter Vogel1, Thomas Schubert2, Hans-Jürgen Schlitt1 and Ulrich Bolder*1 Address: 1Department of Abdominal Surgery, University of Regensburg, 93053 Regensburg, Germany and 2Department of Pathology, University of Regensburg, 93053 Regensburg, Germany Email: Matthias Hornung - [email protected]; Peter Vogel - [email protected]; Thomas Schubert - [email protected]; Hans-Jürgen Schlitt - [email protected]; Ulrich Bolder* - [email protected] * Corresponding author
Published: 15 February 2008 World Journal of Surgical Oncology 2008, 6:19
doi:10.1186/1477-7819-6-19
Received: 15 August 2007 Accepted: 15 February 2008
This article is available from: http://www.wjso.com/content/6/1/19 © 2008 Hornung et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The Krukenberg tumor represents ovarian metastases associated with gastric cancer or other gastrointestinal malignancies. Histology shows typical mucus-production and numerous signet-ring cells. Occasionally Krukenberg tumors have endocrine function and, as a consequence, some patients demonstrate hirsutism and virilization. Case presentation: Here we report a case of virilization associated with an extensive gastric adenocarcinoma and Krukenberg tumor in a premenopausal woman. Virilization occurred three months after diagnosis of gastric cancer and the ovarian tumors. Palliative chemotherapy was initiated as primary therapy, but gastric outlet obstruction required a gastrojejunostomy. In addition, oopherectomy was performed to relieve abdominal tension and to abate hormonal effects. It is likely that virilization of the patient could have been prevented by earlier oopherectomy prior to development of hormone production. Conclusion: Despite the limitation in survival time early oopherectomy should be considered to prevent the development of virilization even in palliative situations if a Krukenberg tumor is diagnosed with gastric cancer.
Background Although incidence and mortality of gastric cancer have decreased over the last decades, it still remains the fourth most common cancer and the second leading cause of cancer-related death worldwide [1,2]. In some cases secondary tumor from gastric signet-cell adenocarcinoma appear in the ovaries. It was first described by Krukenberg in 1896 [3]. Histologically, Krukenberg tumors show diffuse stromal proliferation, mucus-production, and numerous signet-cells that usually can be found in both
ovaries. In general, a mucus-producing gastric carcinoma with signet-cells in the stomach is diagnosed as a primary tumor. McGill et al. showed, that among 233 female
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