AIM： To explore the expression and correlation of CD44v6, vascular endothelial growth factor （VEGF）, matrix metalloproteinase （MMP）-2 and matrix metalloproteinase （MMP）-9 in Krukenberg and primary epithelial ov...AIM： To explore the expression and correlation of CD44v6, vascular endothelial growth factor （VEGF）, matrix metalloproteinase （MMP）-2 and matrix metalloproteinase （MMP）-9 in Krukenberg and primary epithelial ovarian carcinoma. METHODS： The expressions of CD44v6, VEGF, MMP-2 and MMP-9 were detected by immunohistochemical method in 20 cases of normal ovarian tissues, 38 cases of Krukenberg tumor and 45 cases of primary epithelial ovarian carcinoma. RESULTS： The expression of CD44v6 （primary epithelial ovarian carcinoma tissue vs normal ovarian tissue： χ^2= 4.516, P= 0.034; Krukenberg tumor tissue vsnormal ovarian tissue： χ^2 = 19.537, P = 0.001） and VEGF （primary epithelial ovarian carcinoma tissue vs normal ovarian tissue： P = 0.026; Krukenberg tumor tissue vs normal ovarian tissue： χ^2 = 22.895, P = 0.001） was significantly higher in primary epithelial ovarian carcinoma tissue and Krukenberg tumor tissue than in normal ovarian tissue. The positive expression rate of MMP-2 and MMP-9 was 0% in the normal ovarian tissue. The positive expression rate of CD44v6 （ χ^2= 10.398, P= 0.001）, VEGF （ χ^2= 13.149, P = 0.001）, MMP-2 （ χ^2 = 33.668, P = 0.001） and MMP-9 （ χ^2= 38.839, P = 0.001） was remarkably higher in Krukenberg tumor than in primary epithelial ovarian carcinoma. The correlation of CD44v6, VEGF, MMP-2, and MMP-9 was observed in primary epithelial ovarian carcinoma and Krukenberg tumor. CONCLUSION： CD44v6, VEGF, MMP-2, and MMP-9 are involved in ovarian carcinoma, gastric cancer and Krukenberg tumor. Detection of CD44v6, VEGF, MMP-2 and MMP-9 may contribute to the diagnosis of ovarian carcinoma, gastric cancer, and Krukenberg tumor.展开更多
AIM To determine the clinical characteristics of patients undergoing palliative surgery for Krukenberg tumors,including disease presentation,outcomes,and prognostic factors.METHODS This was a retrospective clinical st...AIM To determine the clinical characteristics of patients undergoing palliative surgery for Krukenberg tumors,including disease presentation,outcomes,and prognostic factors.METHODS This was a retrospective clinical study of all patients who underwent palliative surgery for Krukenberg tumors between January 2004 and December 2015.Patient information was obtained from inpatient and outpatient case notes as well as the hospital electronic records.Patients who underwent potential y curative resection,and patients with Krukenberg tumors who did not undergo surgery were also excluded from the study.Palliative surgery was defined as those performed for either alleviation of symptoms or for asymptomatic patients for whom surgical removal of the tumors were deemed necessary following a multidisciplinary consensus.Tumors were diagnosed pre-operatively by computed tomography scans and all had histologic confirmation of the surgical specimens.RESULTS Over the study duration,38 female patients underwent palliative surgery for Krukenberg tumors at our institution.Mean age was 54.2±11.7 years.The colon was the most frequent primary source of metastases(n=21)followed by the stomach(n=4).Prophylactic palliative surgery was performed for eight(21.1%)asymptomatic patients.Median post-operative length of stay was 8 d(IQR 6-12 d).Five patients(13.2%)experienced postoperative complications,although high grade morbidity was only seen in one patient(2.6%).Median overall survival from surgery was 17 mo(95%CI:12.1-21.9)at a median follow-up duration of 12 mo(IQR 8-17mo).The median survival was shorter for patients who underwent emergency surgery,younger patients,those with a colorectal primary,larger tumors,or synchronous peritoneal or hepatic metastases.CONCLUSION Pal iative surgery for Krukenberg tumors can be performed safely with acceptable complication rates.Bilateral oophorectomy should be performed to prevent the risk of symptomatic contralateral tumors.展开更多
We report a case of Krukenberg tumor of gastric origin with adnexal metastasis,in which ultrasonography(US) and contrast-enhanced US(CEUS) played a key diagnostic role.An 64-year-old female patient was referred to ou... We report a case of Krukenberg tumor of gastric origin with adnexal metastasis,in which ultrasonography(US) and contrast-enhanced US(CEUS) played a key diagnostic role.An 64-year-old female patient was referred to our department for abdominal pain,nausea and ascites.US examination was performed as first line diagnostic imaging approach,confirming the presence of ascites and detecting marked thickness of the gastric wall and a right adnexal mass.CEUS was immediately performed and showed arterial enhancement followed by wash-out in the venous phase of both the gastric wall and the adnexal mass,suggesting the diagnosis of gastric cancer with right adnexal metastasis(Krukenberg syndrome).The patient underwent USguided paracentesis and esophagogastroduodenoscopy that showed linitis plastica.Cytologic examination of the peritoneal fluid revealed the presence of signetring cells,and histologic examination of the specimen obtained by endoscopic biopsy showed primary gastric mucus-producing adenocarcinoma with signetring cells.Although transvaginal US is undoubtedly the method of choice to evaluate ovarian tumors,abdominal US and CEUS can provide key diagnostic elements,supporting clinicians in the first steps of the diagnostic work-up of abdominal and pelvic masses.展开更多
We report the first application of pressurized intraperitoneal aerosol chemotherapy(PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-yearold woman with p...We report the first application of pressurized intraperitoneal aerosol chemotherapy(PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-yearold woman with peritoneal carcinomatosis who was primarily diagnosed with and underwent surgery for a Krukenberg tumor. The PIPAC procedure was performed with the use of cisplatin at 7.5 mg/m2 and doxorubicin at 1.5 mg/m2 for 30 min at 37 ℃. Eight weeks after the PIPAC procedure, the patient underwent open classic D2 gastrectomy with the creation of a Roux-en-Y anastomosis(RNY) combined with liver metastasectomy. The patient underwent the classic protocol for chemotherapy combined with Xeloda. The patient felt better and returned to her daily activities. Multicenter data should be gathered to confirm the usefulness of PIPAC as a rescue or neoadjuvant supportive therapy in a very select group of patients who have been recently qualified to undergo classic chemotherapy or standard oncologic surgical procedures.展开更多
Krukenbergtumor is a metastatic ovarian tumor with its primary site being the gastrointestinal tract. The pathogenesis of Krukenberg tumor formation is still in its hypothetical stage though the current understanding ...Krukenbergtumor is a metastatic ovarian tumor with its primary site being the gastrointestinal tract. The pathogenesis of Krukenberg tumor formation is still in its hypothetical stage though the current understanding suggests lymphatic, hematogenous and transcoelomic route as the 3 major route of metastasis. There is a lack of description in the literature related to the pathway of metastasis. Here, we intend to search the available literature and provide a thorough review, which may be helpful to the readers to understand the issue of mechanism of Krukenberg tumor metastasis more clearly.展开更多
Krukenberg tumor, a rare metastatic ovarian tumor arising from gastrointestinal adenocarcinoma mainly, tends to occur in premenopausal females. Finding the origin of a Krukenberg tumor is crucial for determining progn...Krukenberg tumor, a rare metastatic ovarian tumor arising from gastrointestinal adenocarcinoma mainly, tends to occur in premenopausal females. Finding the origin of a Krukenberg tumor is crucial for determining prognosis. In Eastern countries, the most common origin of Krukenberg tumor is stomach cancer, which is generally diagnosed via endoscopic biopsy to investigate an abnormal mucosal lesion. Here, we describe a case of huge adnexal mass in a 33-year-old woman who presented with abdominal distension. Two independent endoscopic examinations performed by experts in two tertiary university hospitals revealed no abnormal mucosal lesion. The patient was diagnosed with a Krukenberg tumor according to findings from random endoscopic biopsies taken from normal-looking gastric mucosa in our hospital. It is very rare to be diagnosed via a random biopsy in cases where three well-trained endoscopists had not found any mucosal lesion previously. Thus, in this case, random biopsy was helpful in finding the origin of a Krukenberg tumor.展开更多
基金Supported by Foundation for Scholars Abroad of Ministry of Education of China, No. [2003]406Foundation of Heilongjiang Office of Education, No. 9551138
文摘AIM： To explore the expression and correlation of CD44v6, vascular endothelial growth factor （VEGF）, matrix metalloproteinase （MMP）-2 and matrix metalloproteinase （MMP）-9 in Krukenberg and primary epithelial ovarian carcinoma. METHODS： The expressions of CD44v6, VEGF, MMP-2 and MMP-9 were detected by immunohistochemical method in 20 cases of normal ovarian tissues, 38 cases of Krukenberg tumor and 45 cases of primary epithelial ovarian carcinoma. RESULTS： The expression of CD44v6 （primary epithelial ovarian carcinoma tissue vs normal ovarian tissue： χ^2= 4.516, P= 0.034; Krukenberg tumor tissue vsnormal ovarian tissue： χ^2 = 19.537, P = 0.001） and VEGF （primary epithelial ovarian carcinoma tissue vs normal ovarian tissue： P = 0.026; Krukenberg tumor tissue vs normal ovarian tissue： χ^2 = 22.895, P = 0.001） was significantly higher in primary epithelial ovarian carcinoma tissue and Krukenberg tumor tissue than in normal ovarian tissue. The positive expression rate of MMP-2 and MMP-9 was 0% in the normal ovarian tissue. The positive expression rate of CD44v6 （ χ^2= 10.398, P= 0.001）, VEGF （ χ^2= 13.149, P = 0.001）, MMP-2 （ χ^2 = 33.668, P = 0.001） and MMP-9 （ χ^2= 38.839, P = 0.001） was remarkably higher in Krukenberg tumor than in primary epithelial ovarian carcinoma. The correlation of CD44v6, VEGF, MMP-2, and MMP-9 was observed in primary epithelial ovarian carcinoma and Krukenberg tumor. CONCLUSION： CD44v6, VEGF, MMP-2, and MMP-9 are involved in ovarian carcinoma, gastric cancer and Krukenberg tumor. Detection of CD44v6, VEGF, MMP-2 and MMP-9 may contribute to the diagnosis of ovarian carcinoma, gastric cancer, and Krukenberg tumor.
文摘AIM To determine the clinical characteristics of patients undergoing palliative surgery for Krukenberg tumors,including disease presentation,outcomes,and prognostic factors.METHODS This was a retrospective clinical study of all patients who underwent palliative surgery for Krukenberg tumors between January 2004 and December 2015.Patient information was obtained from inpatient and outpatient case notes as well as the hospital electronic records.Patients who underwent potential y curative resection,and patients with Krukenberg tumors who did not undergo surgery were also excluded from the study.Palliative surgery was defined as those performed for either alleviation of symptoms or for asymptomatic patients for whom surgical removal of the tumors were deemed necessary following a multidisciplinary consensus.Tumors were diagnosed pre-operatively by computed tomography scans and all had histologic confirmation of the surgical specimens.RESULTS Over the study duration,38 female patients underwent palliative surgery for Krukenberg tumors at our institution.Mean age was 54.2±11.7 years.The colon was the most frequent primary source of metastases(n=21)followed by the stomach(n=4).Prophylactic palliative surgery was performed for eight(21.1%)asymptomatic patients.Median post-operative length of stay was 8 d(IQR 6-12 d).Five patients(13.2%)experienced postoperative complications,although high grade morbidity was only seen in one patient(2.6%).Median overall survival from surgery was 17 mo(95%CI:12.1-21.9)at a median follow-up duration of 12 mo(IQR 8-17mo).The median survival was shorter for patients who underwent emergency surgery,younger patients,those with a colorectal primary,larger tumors,or synchronous peritoneal or hepatic metastases.CONCLUSION Pal iative surgery for Krukenberg tumors can be performed safely with acceptable complication rates.Bilateral oophorectomy should be performed to prevent the risk of symptomatic contralateral tumors.
文摘 We report a case of Krukenberg tumor of gastric origin with adnexal metastasis,in which ultrasonography(US) and contrast-enhanced US(CEUS) played a key diagnostic role.An 64-year-old female patient was referred to our department for abdominal pain,nausea and ascites.US examination was performed as first line diagnostic imaging approach,confirming the presence of ascites and detecting marked thickness of the gastric wall and a right adnexal mass.CEUS was immediately performed and showed arterial enhancement followed by wash-out in the venous phase of both the gastric wall and the adnexal mass,suggesting the diagnosis of gastric cancer with right adnexal metastasis(Krukenberg syndrome).The patient underwent USguided paracentesis and esophagogastroduodenoscopy that showed linitis plastica.Cytologic examination of the peritoneal fluid revealed the presence of signetring cells,and histologic examination of the specimen obtained by endoscopic biopsy showed primary gastric mucus-producing adenocarcinoma with signetring cells.Although transvaginal US is undoubtedly the method of choice to evaluate ovarian tumors,abdominal US and CEUS can provide key diagnostic elements,supporting clinicians in the first steps of the diagnostic work-up of abdominal and pelvic masses.
文摘We report the first application of pressurized intraperitoneal aerosol chemotherapy(PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-yearold woman with peritoneal carcinomatosis who was primarily diagnosed with and underwent surgery for a Krukenberg tumor. The PIPAC procedure was performed with the use of cisplatin at 7.5 mg/m2 and doxorubicin at 1.5 mg/m2 for 30 min at 37 ℃. Eight weeks after the PIPAC procedure, the patient underwent open classic D2 gastrectomy with the creation of a Roux-en-Y anastomosis(RNY) combined with liver metastasectomy. The patient underwent the classic protocol for chemotherapy combined with Xeloda. The patient felt better and returned to her daily activities. Multicenter data should be gathered to confirm the usefulness of PIPAC as a rescue or neoadjuvant supportive therapy in a very select group of patients who have been recently qualified to undergo classic chemotherapy or standard oncologic surgical procedures.
文摘Krukenbergtumor is a metastatic ovarian tumor with its primary site being the gastrointestinal tract. The pathogenesis of Krukenberg tumor formation is still in its hypothetical stage though the current understanding suggests lymphatic, hematogenous and transcoelomic route as the 3 major route of metastasis. There is a lack of description in the literature related to the pathway of metastasis. Here, we intend to search the available literature and provide a thorough review, which may be helpful to the readers to understand the issue of mechanism of Krukenberg tumor metastasis more clearly.
基金Supported by 2013 Research Grant from Kangwon National University,No.C1010351-01-01
文摘Krukenberg tumor, a rare metastatic ovarian tumor arising from gastrointestinal adenocarcinoma mainly, tends to occur in premenopausal females. Finding the origin of a Krukenberg tumor is crucial for determining prognosis. In Eastern countries, the most common origin of Krukenberg tumor is stomach cancer, which is generally diagnosed via endoscopic biopsy to investigate an abnormal mucosal lesion. Here, we describe a case of huge adnexal mass in a 33-year-old woman who presented with abdominal distension. Two independent endoscopic examinations performed by experts in two tertiary university hospitals revealed no abnormal mucosal lesion. The patient was diagnosed with a Krukenberg tumor according to findings from random endoscopic biopsies taken from normal-looking gastric mucosa in our hospital. It is very rare to be diagnosed via a random biopsy in cases where three well-trained endoscopists had not found any mucosal lesion previously. Thus, in this case, random biopsy was helpful in finding the origin of a Krukenberg tumor.
