Krukenberg Tumor of Renal Pelvic Origin: Report of a Case With Selected Comments on Ovarian Tumors Metastatic From the Urinary Tract

Irving, Julie; Vasques, Deette R.; McGuinness, Timothy B.; Young, Robert H.

doi:10.1097/01.pgp.0000185405.08556.a0

Cited by 23 publications

(8 citation statements)

References 19 publications

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“…This occurred in 2 of our cases, and, although it is not the focus of this report, this adds to the known experience of 9 cases of ovarian spread of urachal adenocarcinoma. For that reason, it is worth noting that our immunohistochemical characterization of urachal glandular neoplasms showed an overall similar immunoprofile compared with primary ovarian tumors, CK7 + , CK20 + , CDX2 + , b-catenin À , ER À , and PR À , 38,39 and that this profile did not differ significantly between cystic and noncystic tumors. 34,35,37 Despite its rarity, it is important to have the urachus on the list of possible primary sites when evaluating an ovarian mucinous cystadenocarcinoma with features suggesting spread to the ovary, particularly if the other more common sites of primary neoplasms mimicking primary mucinous tumors of the ovaries, such as appendix and pancreas, are excluded clinically.…”

Section: Discussionmentioning

confidence: 62%

Glandular Neoplasms of the Urachus

Amin

Smith

Eble

et al. 2014

American Journal of Surgical Pathology

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Published experience remains limited for glandular neoplasms of the urachus, especially mucinous cystic tumors. We reviewed 55 glandular urachal neoplasms to evaluate their clinical features and histopathologic spectrum and to devise a classification system for the mucinous cystic forms. Within the 55 cases studied, we observed 2 groups with differing clinical, gross, and histopathologic features. The first group, invasive, noncystic adenocarcinomas (n=24), had clinicopathologic features in accord with the known spectrum of urachal adenocarcinoma (mean age 50 y, female:male ratio 1.7, with recurrence or death from disease in 9/16 cases over a 45 mo mean follow-up). The second group, mucinous cystic tumors (n=31), morphologically resembled mucinous cystic tumors of the ovary and appeared classifiable by the same approach (mean age 47 y, female:male ratio 1.4) and included mucinous cystadenoma (n=4), mucinous cystic tumor of low malignant potential (n=22, including 2 cases with intraepithelial carcinoma), and mucinous cystadenocarcinoma with microscopic (n=4) or frank invasion (n=1). Follow-up information was available for 13 patients with mucinous cystic tumors (mean 41 mo); we observed no local recurrence or distant metastasis. This experience suggests that there is a distinct group of glandular, cystic tumors of the urachus that is classifiable in a manner similar to ovarian neoplasms and that has a favorable prognosis after complete excision. As with cystic neoplasms of other organs, rigorous sampling is recommended to identify potentially small foci of carcinoma that could be missed by inadequate sampling. Accordingly, classification based on methods other than complete surgical excision may be hazardous.

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Section: Discussionmentioning

confidence: 62%

Glandular Neoplasms of the Urachus

Amin

Smith

Eble

et al. 2014

American Journal of Surgical Pathology

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“…46 Pancreas accounted for a higher than usual number of the primaries (6%) in one Japanese series. 46 Pancreas accounted for a higher than usual number of the primaries (6%) in one Japanese series.…”

Section: The Krukenberg Tumormentioning

confidence: 81%

From Krukenberg to Today: The Ever Present Problems Posed by Metastatic Tumors in the Ovary

Young

2006

Advances in Anatomic Pathology

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This review considers historical aspects of metastatic tumors to the ovary, general principles that aid in their evaluation, and metastatic mucinous tumors, including the Krukenberg tumor. The historical timeline on the Krukenberg tumor dates back to the legendary Sir James Paget and the story is followed through the well-known, albeit flawed, contribution of Friedrich Krukenberg and others who have contributed important papers over the years, including the overlooked contribution of the French investigator Gauthier-Villars. Knowledge of metastatic colorectal carcinoma is traced back to the famed British surgeon Sir John Bland-Sutton and followed through to more recent contributions, including the important one of Lash and Hart. Contributions on mucinous tumors conclude the historical perspective, note being made of the recent evidence suggesting that the long held contention of Dr Robert E. Scully that ovarian mucinous tumors in patients with pseudomyxoma peritonei usually originate from the appendix is correct. The section on general principles highlights the many clinical, gross, microscopic, and special techniques such as immunohistochemistry that may aid in determining that an ovarian tumor is metastatic with emphasis on the first 3 mentioned aspects. Problematic features such as a tendency for metastatic tumors to be cystic, even when the primary tumors are not, and for many metastatic tumors to mature in the ovary (so-called maturation phenomenon), are emphasized. Of the many helpful findings that resolve the problem, the characteristic features of surface implants are highlighted. The contribution on the Krukenberg tumor reviews the varied microscopy of this tumor pointing out that the well-known pattern of signet-ring cells in a cellular stroma, albeit characteristic, is often not striking and frequently overshadowed by other microscopic features. The latter include, in many cases, a rather unique microcystic pattern. The final portion of the essay reviews mucinous tumors of non-Krukenberg type, beginning with those that originate from the appendix. The appendiceal neoplasms have distinctive features in most cases being particularly well differentiated, and this is also seen in their ovarian metastases. Other mucinous tumors that commonly simulate closely metastatic neoplasms, include those from the pancreas in particular, but also diverse other sites, are then reviewed.

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“…Yet, there were still rare case reports of Krukenberg tumor originating from carcinomas of small intestine, appendix, gallbladder, breast, pancreas, ampulla of Vater, urinary tract, non-Hodgkin lymphoma, etc [5,[7][8][9][10][11][12][13][14][15]. In our study, of all the 102 cases, stomach was the most common primary site (56, 54.9%), followed by rectum (18,17.7%) and colon (16,15.7%).…”

Section: Discussionmentioning

confidence: 99%

Metastatic factors for Krukenberg tumor: a clinical study on 102 cases

et al. 2010

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To investigate factors associated with gastrointestinal (GI) carcinomas metastasizing to ovaries to form Krukenberg tumor. Among the 102 cases of Krukenberg tumor due to GI cancers, there were 41 cases synchronously diagnosed, 43 cases with primary tumor identified first and 18 cases with ovarian tumor identified first. Metastatic factors of 43 cases of metachronous Krukenberg tumor were analyzed with univariate and multivariate methods. Of the 43 patients, the median age at diagnosis of Krukenberg tumor was 42 years (range, 21-72). Stomach is the most common primary site (58.1%), followed by colon (25.6%) and rectum (16.3%). Most of the patient was in premenopausal state (81.4%) and had bilateral ovaries involved (67.4%). The overall median metastasis-free time in T3 group (17.0 months) was significantly longer than that in T4 group (10.0 months) (P=0.003). Univariate analysis identified tumor invasion depth and ascites as significant factors for metastasis. Multivariate analysis confirmed that invasion depth was the only significant metastatic factor (Relative Risk: 3.2, P=0.004). Primary carcinomas T stage is the most important predictor of Krukenberg tumor from GI cancer.

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Krukenberg Tumor of Renal Pelvic Origin: Report of a Case With Selected Comments on Ovarian Tumors Metastatic From the Urinary Tract

Cited by 23 publications

References 19 publications

Glandular Neoplasms of the Urachus

Glandular Neoplasms of the Urachus

From Krukenberg to Today: The Ever Present Problems Posed by Metastatic Tumors in the Ovary

Metastatic factors for Krukenberg tumor: a clinical study on 102 cases

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