Affiliated Hospital of North China University of Science and Technology, Gastrointestinal Oncology Treatment Center, Tangshan, Hebei, China.
Affiliated Hospital of North China University of Science and Technology, Breast Disease Treatment Center, Tangshan, Hebei, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40397. doi: 10.1097/MD.0000000000040397.
Small bowel adenocarcinoma (SBA) is an extremely rare tumor that is not fully understood, SBA accounts for less than 5% of gastrointestinal cancers, Krukenberg tumors account for a lower proportion of all ovarian tumors, close to 2%. Stomach is the most common primary site of Krukenberg tumor. The phenomenon of bilateral ovarian Kukenberg tumor caused by implantation and metastasis of small bowel cancer is extremely rare, with few literature reports and limited clinical diagnosis and treatment data. We present a case of a 55-year-old woman with bilateral Kukenberg's tumor caused by small bowel cancer implantation and share our views on the diagnosis and treatment of this case.
A 55-year-old woman presented with vaginal bleeding and persistent lower abdominal pain after fatigue 10 days ago. Pelvic ultrasound at a local hospital revealed 2 solid masses in her pelvis, and she came to our hospital for further diagnosis and treatment. The results of colonofiberscope examination and histopathological examination confirmed intramucosal adenocarcinoma in the small intestine.
The results of colonofiberscope examination and histopathological examination confirmed intramucosal adenocarcinoma in the small intestine. Contrast-enhanced computed tomography showed multiple cystic space-occupying lesions in the pelvic cavity, and the possibility of ovarian tumor was considered.
Radical treatment of right half colon cancer and pelvic mass resection were performed under general anesthesia. Combined with intraoperative and postoperative pathological examination, the diagnosis was mucinous adenocarcinoma of the small intestine stage IV (pT4N1M1). Bilateral ovarian metastasis, metastatic cancer (3/19): lymph nodes around the small intestine (3/12), lymph nodes around the colon (0/7).
He is currently receiving chemotherapy, the chemotherapy regimen is XELOX regimen. The specific drugs were oxaliplatin and capecitabine.
SBA is often difficult to diagnose due to few specific symptoms and is usually detected at stage IV. Bilateral ovarian Kukenberg tumor caused by small bowel cancer implantation metastases is extremely rare, and clinicians must be vigilant for women with fewer specific symptoms of gastrointestinal discomfort and conduct further diagnostic studies to avoid delayed diagnosis and treatment.
小肠腺癌（SBA）是一种极为罕见的肿瘤，目前尚未完全阐明其发病机制。SBA 占胃肠道癌症的比例不足 5%，而克鲁肯伯格瘤在所有卵巢肿瘤中的比例则更低，接近 2%。胃是克鲁肯伯格瘤的最常见原发部位。由小肠癌种植和转移引起的双侧卵巢克鲁肯伯格瘤极为罕见，文献报道较少，临床诊治数据有限。我们报告了 1 例由小肠癌种植和转移引起的 55 岁女性双侧克鲁肯伯格瘤病例，并就该病例的诊治提出见解。
一名 55 岁女性因疲劳后阴道出血和持续性下腹疼痛就诊，10 天前出现该症状。当地医院盆腔超声显示盆腔内有 2 个实性肿块，遂来我院进一步诊治。结肠镜检查和组织病理学检查结果证实为小肠黏膜内腺癌。
结肠镜检查和组织病理学检查结果证实为小肠黏膜内腺癌。盆腔增强 CT 显示盆腔内有多个囊性占位性病变，考虑卵巢肿瘤可能性大。
全身麻醉下行右半结肠根治术和盆腔肿块切除术。结合术中及术后病理检查，诊断为Ⅳ期（pT4N1M1）小肠黏液腺癌。双侧卵巢转移，转移性癌（3/19）：小肠旁淋巴结（3/12）、结肠旁淋巴结（0/7）。
目前患者接受化疗，化疗方案为 XELOX 方案，具体药物为奥沙利铂和卡培他滨。
SBA 由于症状特异性少，常难以诊断，通常在Ⅳ期时才被发现。由小肠癌种植转移引起的双侧卵巢克鲁肯伯格瘤极为罕见，临床医生对于胃肠不适症状较少的女性患者必须保持警惕，进行进一步的诊断性研究，以避免延误诊断和治疗。
