A Case Study on the Diagnostic Complexity of Krukenberg Tumor in Pregnancy: Clinical Insights and Management
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Abstract
Krukenberg tumors, metastatic ovarian carcinomas primarily originating from gastrointestinal malignancies, present significant diagnostic and therapeutic challenges during pregnancy. We report a case of a 39-year-old pregnant woman initially diagnosed with autoimmune pancreatitis (AIP) and cholestasis of pregnancy, later found to have metastatic signet ring cell carcinoma of the stomach with ovarian involvement. This case highlights the complexities in differentiating malignancy from benign hepatobiliary disorders during pregnancy, emphasizing the need for a multidisciplinary approach. Early integration of tumor markers, advanced imaging, and HISORt criteria can facilitate timely diagnosis and improve clinical outcomes.
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[3] Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017 Jun;34(5):295-307. https://doi.
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[5] Lengyel E. Ovarian cancer development and metastasis. Am J Pathol. 2010 Sep;177(3):1053-64. https://doi.org/10.2353/ajpath.2010.100105
[6] Zhang J, Peng P, Cao D, Yang J, Shen K. Clinicopathological features and maternal and foetal management of pregnancycomplicating Krukenberg tumours. Mol Clin Oncol. 2020 Jun;12(6):581-7. https://doi.org/10.3892/mco.2020.2025
[7] Uyeturk U, Arslan SH, Bal O, Arslan UY, Oksuzoglu OB. Isolated ovarian metastasis of gastric cancer: Krukenberg
tumor. Contemp Oncol (Pozn). 2013;17(6):515-9. https://doi.org/10.5114/wo.2013.37542
[8] O’Reilly DA, Malde DJ, Duncan T, Rao M, Filobbos R. Review of the diagnosis, classification and management of autoimmune pancreatitis. World J Gastrointest Pathophysiol. 2014 May 15;5(2):71-81. https://doi.org/10.4291/wjgp.v5.i2.71
[9] Kazemi F, Nahidi F, Kariman N. Disorders Affecting Quality of Life During Pregnancy: A Qualitative Study. J Clin Diagn
Res. 2017 Apr;11(4):QC06-QC10. https://doi.org/10.7860/JCDR/2017/23703.9560
[10] Ercan CM, Sakinci M, Dede M, et al. Tumor markers in normal pregnancy. Arch Gynecol Obstet. 2011;284(3):635-8.
[11] Han SN, Lotgerink A, Gziri MM, Van Calsteren K, Hanssens M, Amant F. Physiologic variations of serum tumor
markers in gynecological malignancies during pregnancy: a systematic review. BMC Med. 2012 Aug 8;10:86. https://doi.
org/10.1186/1741-7015-10-86
[12] Zhang Y, Du H, Li T, Li H, Deng Y, Wu R. Krukenberg Tumor of Gastric Origin in Pregnant Women with Preeclampsia. Case Rep Oncol. 2023;16(1):718-27. https://doi.org/10.1159/000531991
[13] Dłuski D, Szamatowicz J, Szamatowicz M. Krukenberg Progression of Gastric Carcinoma in Pregnancy: Is Early
Diagnosis Possible? J Clin Med. 2023;12(16):5397. https://doi.org/10.3390/jcm12165397
review. Avicenna J Med. 2017 Oct-Dec;7(4):153-7. https://doi.org/10.4103/ajm.AJM_22_17
[2] Franciszek Dłuski D, Mierzyński R, Poniedziałek-Czajkowska E, Leszczyńska-Gorzelak B. Ovarian Cancer and Pregnancy-A Current Problem in Perinatal Medicine: A Comprehensive Review. Cancers (Basel). 2020 Dec 16;12(12):3795. https://doi.org/10.3390/cancers12123795
[3] Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017 Jun;34(5):295-307. https://doi.
org/10.1007/s10585-017-9856-8
[4] Cift T, Aydogan B, Akbaş M, Aydın B, Demirkiran F, Bakkaloglu DV, Ilvan S. Case report: gastric carcinoma diagnosed at the second trimester of pregnancy. Case Rep Obstet Gynecol.2011;2011:532854.https://doi.org/10.1155/2011/532854
[5] Lengyel E. Ovarian cancer development and metastasis. Am J Pathol. 2010 Sep;177(3):1053-64. https://doi.org/10.2353/ajpath.2010.100105
[6] Zhang J, Peng P, Cao D, Yang J, Shen K. Clinicopathological features and maternal and foetal management of pregnancycomplicating Krukenberg tumours. Mol Clin Oncol. 2020 Jun;12(6):581-7. https://doi.org/10.3892/mco.2020.2025
[7] Uyeturk U, Arslan SH, Bal O, Arslan UY, Oksuzoglu OB. Isolated ovarian metastasis of gastric cancer: Krukenberg
tumor. Contemp Oncol (Pozn). 2013;17(6):515-9. https://doi.org/10.5114/wo.2013.37542
[8] O’Reilly DA, Malde DJ, Duncan T, Rao M, Filobbos R. Review of the diagnosis, classification and management of autoimmune pancreatitis. World J Gastrointest Pathophysiol. 2014 May 15;5(2):71-81. https://doi.org/10.4291/wjgp.v5.i2.71
[9] Kazemi F, Nahidi F, Kariman N. Disorders Affecting Quality of Life During Pregnancy: A Qualitative Study. J Clin Diagn
Res. 2017 Apr;11(4):QC06-QC10. https://doi.org/10.7860/JCDR/2017/23703.9560
[10] Ercan CM, Sakinci M, Dede M, et al. Tumor markers in normal pregnancy. Arch Gynecol Obstet. 2011;284(3):635-8.
[11] Han SN, Lotgerink A, Gziri MM, Van Calsteren K, Hanssens M, Amant F. Physiologic variations of serum tumor
markers in gynecological malignancies during pregnancy: a systematic review. BMC Med. 2012 Aug 8;10:86. https://doi.
org/10.1186/1741-7015-10-86
[12] Zhang Y, Du H, Li T, Li H, Deng Y, Wu R. Krukenberg Tumor of Gastric Origin in Pregnant Women with Preeclampsia. Case Rep Oncol. 2023;16(1):718-27. https://doi.org/10.1159/000531991
[13] Dłuski D, Szamatowicz J, Szamatowicz M. Krukenberg Progression of Gastric Carcinoma in Pregnancy: Is Early
Diagnosis Possible? J Clin Med. 2023;12(16):5397. https://doi.org/10.3390/jcm12165397
| Files | ||
| Issue | Vol 10 No 1 (2025): January-February | |
| Section | Case Report(s) | |
| Keywords | ||
| Krukenberg tumor Pregnancy Autoimmune pancreatitis | ||
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How to Cite
1.
Zafarbakhsh A, Mousavi Seresht L, Souri S, Riyahi S. A Case Study on the Diagnostic Complexity of Krukenberg Tumor in Pregnancy: Clinical Insights and Management. CRCP. 2025;10(1):29-34.
