From the Department of Radiology, University of California-San Diego Medical Center, San Diego, CA.
J Comput Assist Tomogr. 2024;48(3):382-387. doi: 10.1097/RCT.0000000000001570. Epub 2023 Dec 18.
The purpose of this report was to present the computed tomography (CT) and magnetic resonance imaging (MRI) features of Krukenberg tumors and to review the pertinent clinical data about the rising incidence of this malignancy among young women.
This series included 8 women who ranged in age from 24 to 44 years (mean, 36.3 years). They were diagnosed to have Krukenberg tumors during a 5-year period (2011-2016). All patients were evaluated by abdominal CT and pelvic or transvaginal sonography. Five of them also had MRI of the abdomen, and 3 had positron emission tomography scans.
The primary cancer was located in the stomach of 7 patients and in the colon in 1. The initial presentation was due to large pelvic mass and abdominal distention by ascites in 3 patients, gastrointestinal symptoms in 4, and small bowel obstruction by carcinoma of the ascending colon in 1 woman. Ovarian metastases were demonstrated on the initial imaging examination of 5 patients and developed as metachronous lesion during follow-up in 3 cases. Six women died 3 to 23 months (mean, 11 months) after the diagnosis. One has survived for 6 years after extensive surgery, and 1 was lost to follow-up.
Krukenberg tumors are being diagnosed with an increasing frequency because of well-documented rising incidence of gastric and colorectal carcinomas among young women. Therefore, those presenting with gastrointestinal cancer should have careful imaging of their ovaries for possible metastases, and conversely, the clinical or sonographic detection of bilateral ovarian masses would require evaluation by CT or MRI of the abdomen in search for a potential primary gastrointestinal cancer. This report highlights the CT and MRI features of this neoplastic process and reviews the current concepts about its development and management.
本报告旨在介绍库肯勃瘤的计算机断层扫描（CT）和磁共振成像（MRI）特征，并回顾近年来年轻女性中这种恶性肿瘤发病率上升的相关临床数据。
本系列包括 8 名年龄在 24 至 44 岁之间（平均 36.3 岁）的女性患者。她们在 5 年内（2011-2016 年）被诊断为库肯勃瘤患者。所有患者均接受了腹部 CT 和盆腔或经阴道超声检查。其中 5 例还进行了腹部 MRI 检查，3 例进行了正电子发射断层扫描检查。
7 例患者的原发癌位于胃部，1 例位于结肠。3 例患者最初表现为巨大盆腔肿块和腹水引起的腹部膨胀，4 例患者有胃肠道症状，1 例患者因升结肠癌引起小肠梗阻。5 例患者在初始影像学检查中发现卵巢转移，3 例患者在随访中出现同步性病变。6 例患者在诊断后 3 至 23 个月（平均 11 个月）死亡。1 例患者在广泛手术后存活了 6 年，1 例患者失访。
由于年轻女性胃癌和结直肠癌发病率的明确上升，库肯勃瘤的诊断频率也越来越高。因此，对于患有胃肠道癌症的患者，应仔细检查其卵巢是否有转移的可能，反之，如果临床或超声检查发现双侧卵巢肿块，则需要进行腹部 CT 或 MRI 检查，以寻找潜在的胃肠道原发性癌症。本报告重点介绍了这种肿瘤过程的 CT 和 MRI 特征，并回顾了其发生和管理的最新概念。
