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BMJ Case Reports 2013; doi:10.1136/bcr-2012-008302
  • CASE REPORT

Dyspnoea and the ovaries: a rare presentation of Krukenberg tumour

  1. Rafael L Perez2
  1. 1Department of Medicine, University of Louisville, Louisville, Kentucky, USA
  2. 2Department of Pulmonary, Critical Care & Sleep Medicine, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Karim El-Kersh, kaelke01{at}louisville.edu

Summary

Krukenberg tumour is a metastatic signet-ring adenocarcinoma of the ovary, usually with a gastrointestinal primary detected metachronously or synchronously. We present here a case of a 48 year-old woman who presented with a prolonged history of dyspnoea on exertion. Workup had revealed a pelvic mass. Thoracocentesis of her pleural effusion, with cytology, and pathology reports from her total abdominal hysterectomy with bilateral salpingo-oophorectomy revealed a carcinoma with signet-ring cells. Immunostains were positive for CDX2, CK7 and CK20, which was highly suggestive of a gastric primary. Colonoscopy was negative, and an oesophagogastroduodenoscopy revealed a few small crater ulcers, the biopsy of which was negative for cancer. A right-sided pleurodesis was performed for the unremitting malignant effusion, and a PleurX catheter was placed in her left pleural space. She was discharged home with a very poor prognosis.

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