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Case Report

Tubular Variant of Krukenberg Tumour with an Occult Primary

Sumit Giri* , Sumit Giri* , Parul Singhal* , Savitri Singh** , Priyanka Chadha*** , Aparna Kandelwal***

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Indian Journal of Pathology: Research and Practice 5(3):p 413-415, Sept - Dec 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.5316.31

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Abstract

 Krukenberg tumor is a rare tumour and accounts for 1% to 2% of all ovarian neoplasms. It is an uncommon metastatic signet ring cell adenocarcinoma of the ovary, originating in the stomach in the vast majority of cases. On occasions, the gastric cancer may be small and remains undetected for several years after oophorectomy. Much less frequently, the primary tumor is in the large intestine, breast, gallbladder, uterine cervix, appendix, or urinary bladder. Tubular variant of Krukenberg tumour with an occult primary can cause diagnostic dilemma on histopathological examination by mimicking primary ovarian tumours like SertoliLeydig cell tumour, endometrioid carcinoma (primary or metastatic) or clear cell carcinoma. Distinction from primary ovarian tumours is very important as misdiagnosis of Krukenberg tumour as primary ovarian tumour can lead to suboptimal treatment of the patient. We report a case of tubular variant of Krukenberg tumour with occult primary in a 42 year old female and discuss the diagnostic dilemma that arise in such situation. Gross examination of the specimen revealed asymmetricallly enlarged bilateral ovaries having bosselated outer surface with few cysts. Histopathological examination of both the ovaries revealed mucin laden cells in tubular configuration as well as diffusely scattered signet ring cells in a cellular ovarian stroma.The primary site of tumour could not be identified even after through radiographic and endoscopic examination of the patient. The prognoses for patients with this type of metastatic tumor are poor, most die within the first year of evolution. There are rare cases in which patients survive several years.

Keywords: Krukenberg Tumour; Tubular Variant; Ovary.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.5316.31

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