Incidental Ovarian Mass Leading to the Diagnosis of Krukenberg Tumor in a Young Woman Presenting with Bowel Obstruction

Abstract

Krukenberg tumors are rare metastatic ovarian cancers, predominantly originating from gastric adenocarcinoma.  They often show nonspecific gastrointestinal symptoms, which lead to a delayed diagnosis and a poor prognosis. This case report exemplifies the challenges associated with diagnostic delays of Krukenberg tumor, especially in distinguishing metastatic ovarian tumors from primary ovarian cancer, and the limited treatment options available in the advanced stages of the disease, which can affect patients' prognosis. Case Presentation: A 29-year-old female of African descent was experiencing stomach pain and vomiting.  Imaging revealed bilateral ovarian neoplasms associated with ascites and intestinal obstruction. An exploratory laparotomy revealed fragile ovarian and omental tumors, which were subsequently excised. Histopathological analysis: Hematoxylin and Eosin revealed diffusely invasive growing cancerous tissue with granular and diffuse single distribution in which numerous tumor cells had a signet–ring appearance indicative of a Krukenberg tumor from the stomach.  Despite postoperative recovery and subsequent admission for treatment, the patient encountered recurrent obstruction and ultimately succumbed. Discussion and Conclusion: When young women have bilateral ovarian masses and gastrointestinal symptoms Krukenberg tumor should be a differential diagnosis. Timely diagnosis is warranted to facilitate prompt surgical and oncological intervention. When diagnosing metastatic ovarian cancer, immunohistochemistry, cytokeratin markers CK20 and CK7 are frequently used. A multidisciplinary approach is essential to enhance patient outcomes and improve quality of life, even in palliative care settings.