A Krukenberg tumor is a type of ovarian tumor which starts in another area of the body and migrates to the ovaries. Around five to six percent of ovarian cancers present as Krukenberg tumors, and the prognosis for patients with this type of tumor is not good. Because these tumors are secondary metastases, rather than primary tumors, identifying one means that a patient has an underlying primary cancer which may have spread to other areas of the body, which would complicate treatment considerably.
These tumors can arise from malignant cells in any mucin-secreting area of the body. The tumor is known as an adenocarcinoma, a reference to the fact that it originates in glandular tissue, and cancers of the breast and gastrointestinal tract are most likely to give rise to a Krukenberg tumor. Historically, people thought that the cancer cells drifted across the abdomen to the site of the ovaries, but there is evidence that they can be carried in the blood or lymph as well.
When a Krukenberg tumor is examined by a pathologist, specialized cells known as signet ring cells are seen. These cells are so filled with mucin that the nucleus of the cell is pushed to one side, and they do vaguely resemble signet rings, hence the name. An alternate name for this type of tumor is a signet ring cell carcinoma; such cancerous tumors can also be found in other areas of the body.
When a Krukenberg tumor is identified, the first step is to figure out where the cancerous cells came from. This information is important when deciding on a course of treatment. In some cases, for example, surgery may be a good option to remove the tumor and other cancerous cells. In others, chemotherapy and radiation with no surgery may be better options to attempt to shrink the cancer or at least halt its spread through the body.
An oncologist can provide more specific information about a prognosis on the basis of the primary site of the cancer, the extent of the spread, and the patient's condition. When evaluating treatment options, patients may also want to consider quality of life issues in addition to the prognosis. For example, one patient may experience a few months of poor quality of life with a decent chance of recovery and relative comfort after that, making treatment well worth it, while another may not have a very long prognosis and may be faced with permanent quality of life issues caused by the cancer treatment.
