A Case of Krukenberg Tumor Metastasized from Colon Cancer Subsequent to Synchronous Multiple Liver Metastasis

Abstract

: A 34-year-old woman with synchronous, multiple liver metastases of stage IV, T4N2M0H2P0 descending colon cancer was referred to our hospital. The lesion was considered unresectable because of insufficient estimated future remnant liver volume resulting from invasion of three hepatic veins and the hepatic hilum, and she underwent laparoscopic left hemicolectomy. The patient underwent 14 courses of mFOLFOX6 5-flurouracil, leucovorin and oxaliplatin and 21 cetuximab administrations as rst-line chemotherapy, which allowed her to maintain a complete response for 6 months despite adverse reactions such as mild neutropenia and thrombocytopenia. However, abdominal computed tomography CT revealed a large ovarian mass 6 months after chemotherapy cessation. A bilateral adnexectomy at another hospital revealed involvement of both ovaries, and immunohistochemistry revealed that the tumor was CK7 and CK20 , compatible with a colon cancer origin. The ovarian lesions were histologically diagnosed as Krukenberg tumor metastasized from the colon cancer. This case highlights the possibility of metastatic tumor development from colon cancer.