Case ReportThe role of surgical excision for the Krukenberg tumour: A case report

- Krukenberg tumours are an uncommon manifestation of colorectal cancer that has been traditionally associated with poor prognosis.
- Krukenberg tumours are chemo-resistant and commonly present with concomitant peritoneal disease, suggesting a transcoloemic spread that differs from other solid organ colorectal metastases.
- Cytoreductive surgery for isolated ovarian metastasis without peritoneal metastatic disease is recommended for symptom control and offers survival benefit.
- Combined cytoreductive surgery and intraperitoneal chemotherapy for Krukenberg tumours with peritoneal metastatic disease shows promise.

IntroductionKrukenberg 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.Presentation of caseThe 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 23 cm tumour as well as the contralateral ovary and isolated peritoneal disease, with an R0 resection achieved.DiscussionKT 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.ConclusionThis 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.