Lam David, Ong Eugene
Department of Colorectal Surgery, St Vincent's Hospital Melbourne, 41 Victoria Street, Fitzroy, VIC 3065, Australia.
Department of Colorectal Surgery, St Vincent's Hospital Melbourne, 41 Victoria Street, Fitzroy, VIC 3065, Australia; General Surgery and Gastroenterology Clinical Institute, Epworth Freemasons, 166 Clarendon Street, East Melbourne, VIC 3002, Australia.
Int J Surg Case Rep. 2017;38:185-188. doi: 10.1016/j.ijscr.2017.07.046. Epub 2017 Jul 25.
Krukenberg tumour (KT), which represents carcinoma in the ovary, is an uncommon manifestation of metastatic colorectal cancer. It is associated with poor prognosis and a high incidence of peritoneal metastatic disease.
The authors present a case of a 51-year-old female who had a symptomatic, metachronous right ovarian KT diagnosed 12 months after her initial resection. Surgery was performed to excise the 23cm tumour as well as the contralateral ovary and isolated peritoneal disease, with an R0 resection achieved.
KT from colorectal origin behave differently to non-ovarian colorectal metastases, with features suggestive of transcoloemic dissemination. Surgical removal of isolated ovarian metastasis without peritoneal involvement is associated with improved outcomes. Treatment with cytoreductive surgery and heated intraperitoneal chemotherapy offers promise for patients with KT and concominant peritoneal involvement.
This case is illustrative of the clinical features of KT including its chemo-resistance and concomitant carcinomatosis peritoneii. Cytoreductive surgery for KT provides symptom control and confers survival benefit in selected patients.
库肯勃瘤（KT）是卵巢癌的一种表现形式，是转移性结直肠癌的罕见表现。它与预后不良和腹膜转移疾病的高发病率相关。
作者报告了一例51岁女性病例，该患者在初次切除术后12个月被诊断出患有有症状的异时性右卵巢KT。进行了手术，切除了23厘米的肿瘤以及对侧卵巢和孤立的腹膜病灶，实现了R0切除。
结直肠来源的KT与非卵巢结直肠转移的表现不同，具有经结肠播散的特征。手术切除无腹膜受累的孤立性卵巢转移与改善预后相关。细胞减灭术和热腹腔内化疗为伴有腹膜受累的KT患者带来了希望。
该病例说明了KT的临床特征，包括其化疗耐药性和并发的腹膜癌病。KT的细胞减灭术可控制症状，并为部分患者带来生存益处。
