What is a Krukenberg Tumour?
A Krukenberg tumour is a rare form of ovarian cancer that develops when cancer cells from another part of the body spread to the ovaries. Unlike primary ovarian cancer, this tumour is metastatic in nature, meaning it originates elsewhere, most often in the stomach or gastrointestinal tract.
It is usually diagnosed in women between 30 and 50 years of age and often signals advanced disease. Because it spreads from another organ, it is considered a secondary ovarian tumour and is associated with a more challenging outcome.
Causes and Risk Factors
The main cause of Krukenberg tumour is the transfer of malignant cells from the stomach, colon, or appendix to the ovaries, either through the blood circulation or the lymphatic system. The most frequent source is a stomach cancer known as signet-ring cell adenocarcinoma. Although hereditary gastric cancer syndromes and genetic predisposition may increase the risk, most cases arise from pre-existing cancers in the digestive system.
Symptoms
Early stages may not show clear symptoms, which makes diagnosis difficult. As the disease progresses, women commonly report abdominal or pelvic pain, bloating, and an unusual feeling of fullness after eating even small meals. Menstrual cycle disturbances or abnormal vaginal bleeding may appear, along with weight loss, loss of appetite, weakness, and fatigue. These symptoms are often mistaken for those of primary ovarian cancer, which can delay timely diagnosis.
Diagnosis
Diagnosis requires multiple investigations. Imaging techniques such as ultrasound and CT scans are used to detect ovarian masses. To locate the primary tumour, doctors may perform endoscopy or colonoscopy, particularly when stomach or intestinal cancer is suspected.
A biopsy of the ovarian tissue provides the final confirmation. Under the microscope, pathologists identify signet-ring cells, which are characteristic of Krukenberg tumours. Detecting the original site of cancer is vital for deciding the treatment plan.
Treatment
Treatment usually involves a combination of surgery and chemotherapy. Surgical removal of the ovaries and surrounding affected tissues may be done, especially in limited disease. Chemotherapy is essential because it helps target both the primary gastrointestinal tumour and the ovarian spread. Targeted therapies may also be considered in selected cases, while radiation therapy generally has little benefit in this condition.
Prognosis
The prognosis of Krukenberg tumour remains poor because most patients are diagnosed at an advanced stage when cancer has already spread widely. Despite this, aggressive treatment can sometimes prolong survival and improve quality of life. Early recognition of symptoms, combined with prompt investigation and supportive care, is crucial to improving outcomes.
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