Unusual Presentation of Krukenberg Tumour in a young patient
Introduction and case report description:
Krukenberg tumour is a metastatic tumour of ovary, on an average seen in the age group of 45 years.
Description of the problem:
A 27year old unmarried nulliparous female came to the OPD with the complaints of intermittent pain abdomen, mass per abdomen, loss of weight and appetite and distended abdomen. On abdominal examination, mass equivalent to 28-30 weeks of gestation, firm in consistency, bosselated surface was found. USG showed left ovarian mass with solid and cystic components. Right adnexa showed predominantly solid mass with few cystic areas.
Initially, bilateral ovarian cyst was considered to be the primary lesion for which she underwent laparotomy, left salphingo oophorectomy and right ovarian cystectomy. Intra-operatively, bilateral ovarian solid and cystic masses were seen along with gastric epiploic nodal involvement. On HPE, mucin laden signet ring cells were seen. Endoscopy revealed stomach to be the primary lesion. She is currently undergoing chemotherapy.
Clinico-radiologically, the following were considered:
A) Possibility of dysgerminoma
B) Bilateral ovarian cyst
C) Krukenberg tumour
In 1896, Friedrich Ernst Krukenberg first described this rare entity with median survival range being 14-16 months.
Krukenberg tumour is a metastatic tumour with grave prognosis. Radiology and clinical presentation are pointers to the diagnosis; histopathology being the gold standard.
Implication for clinical practice:
This case highlights the unusual occurrence of Krukenberg tumour in young age. It is of utmost importance to identify this tumour even in young patients, as it will affect the prognosis and survival of the patient.