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- W2978556858 abstract "A 48-year-old woman presented to our clinic with abdominal bloating, early satiety, increased abdominal girth and right sided abdominal pain. Physical examination showed palpable abdominal mass. A CT of the abdomen and pelvis confirmed 20 x 9.6cm mass arising from the right ovary (Figure 1). Serum CA-125 and CEA levels were within normal limits. The patient underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy. On exploratory laparotomy, right ovary was multiloculated, cystic with a smooth capsule, uterus and remaining pelvic viscera was normal. Intraoperatively, bowel was inspected from the cecum to ligament of Treitz and no abnormality was found. Operative pathology revealed signet ring cell metastatic carcinoma. Histopathology with immunochemistry showed diffuse immunoreactivity in epithelial signet ring cells. CK20 was positive, CDX2 showed nuclear reactivity and CK19.9 was focally positive, CK7, ER, synaptophysin, chromogranin, CD56, GCDFP-15 and CA125 was negative supporting colonic origin of this metastatic carcinoma (Figure 2). Given concern for colon cancer and primary GI origin, the patient underwent diagnostic workup with mammogram upper and lower endoscopy with random biopsies which all failed to show primary origin of the tumor. Further imaging with PET scan did not show any metastatic lesions.Figure 1Figure 2A Krukenberg tumor is a metastatic signet ring cell adenocarcinoma of the ovary that metastasized from a primary site, classically the gastrointestinal tract. Rarely, breast, uterine endometrium, thyroid, urinary bladder, kidney and lungs are also found to be of primary malignancy. It is considered as advanced disease with very poor prognosis with average survival time between 3-10 months and only 10% of the patients survive more than two years. We report a metastatic signet ring cell carcinoma of ovary from a colonic origin with normal colonoscopy findings which was successfully treated with removal of ovarian lesion. Our patient had excellent postoperative recovery and no adjuvant treatment was offered. Close follow up was advised since primary carcinoma sometimes may remain undetected for several years after oophorectomy. She remained cancer free during 4-year follow up (Figure 3).Figure 3" @default.
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- W2978556858 date "2016-10-01" @default.
- W2978556858 modified "2023-09-27" @default.
- W2978556858 title "Krukenberg Tumor with Colonic Origin and Normal Colonoscopy: Where Did It Come From?" @default.
- W2978556858 doi "https://doi.org/10.14309/00000434-201610001-02599" @default.
- W2978556858 hasPublicationYear "2016" @default.
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