Laparoscopic En Bloc Resection of Colon Cancer with Ovarian Metastasis
Amruta Jaiswal, Shazia Khan
Citation Information :
Jaiswal A, Khan S. Laparoscopic En Bloc Resection of Colon Cancer with Ovarian Metastasis. J South Asian Feder Obs Gynae 2020; 12 (1):45-47.
Most common primary malignancies linked to Krukenberg tumors are those arising from the gastrointestinal tract. Complete cytoreduction is the key to reduce reoccurrence. We report a case of a 34-year-old woman presented with bilateral Krukenberg tumor with no gastrointestinal symptoms or sign; further preoperative evaluation revealed malignant growth in the sigmoid colon. Laparoscopic total hysterectomy, bilateral salpingo-oophorectomy with anterior colonic resection was performed. Histopathology suggested Krukenberg tumor arising from moderately differentiated adenocarcinoma of the colon with further confirmation on immunohistochemistry. The patient had uneventful recovery with no documented evidence of locoregional reoccurrence till date. This case highlights the importance of thorough preoperative evaluation to detect occult primary in the case of Krukenberg tumor; further, it justifies the use of minimal access surgery for en bloc resection of Krukenberg tumor along with primary colonic malignancy.
Krukenberg F. Ueber das fibrosarcoma ovarii mucocellulare (carcinomatodes). Arch Gynecol Obstet 1896;50(2):287–321.
Lu LC, Shao YY, Hsu CH. Metastasectomy of Krukenberg tumors may be associated with survival benefits in patients with metastatic gastric cancer. Anticancer Res 2012;32(8):3397–3401.
Rosa F, Marrelli D, Morgagni P. Krukenberg tumors of gastric origin: the rationale of surgical resection and perioperative treatments in a multicenter western experience. World J Surg 2016;40(4):921–928. DOI: 10.1007/s00268-015-3326-8.
Jiang R, Tang J, Cheng X, et al. Surgical treatment for patients with different origins of Krukenberg tumors: outcomes and prognostic factors. Euro J Surg Oncol (EJSO) 2009;35(1):92–97. DOI: 10.1016/j.ejso.2008.05.006.
Moore RG, Chung M, Granai CO, et al. Incidence of metastasis to the ovaries from nongenital tract primary tumors. Gynecol Oncol 2004;93(1):87–91. DOI: 10.1016/j.ygyno.2003.12.039.
Chen CY, Wu YC, Yen MS, et al. The power Doppler velocity index, pulsatility index, and resistive index can assist in making a differential diagnosis of primary ovarian carcinoma and Krukenberg tumors a preliminary study. J Ultrasound Med 2007;26(7):921–926. DOI: 10.7863/jum.2007.26.7.921.
Hunter JA, Ryan JA, Schultc P. En bloc resection of colon cancer adherent to other organs. Am J Surg 1987;154(1):49–53. DOI: 10.1016/0002-9610(87)90292-3.
Orcutt ST, Marshall CL, Robinson CN, et al. Minimally invasive surgery in colon cancer patients leads to improved short-term outcomes and excellent oncologic results. Am J Surg 2011;202(5):528–531. DOI: 10.1016/j.amjsurg.2011.06.024.
Tai DK, Li WH, Cheung MT. Krukenberg tumours of colorectal origin: experience of a tertiary referral centre and review of the literature. Surg Pract 2012;16(2):46–52. DOI: 10.1111/j.1744-1633.2012.00592.x.
Lewis MR, Deavers MT, Silva EG, et al. Ovarian involvement by metastatic colorectal adenocarcinoma: still a diagnostic challenge. Am J Surg Pathol 2006;30(2):177–184. DOI: 10.1097/01.pas.0000176436.26821.8a.
