 a krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast. gastric adenocarcinoma, especially at the pylorus, is the most common source. krukenberg tumors are often (over 80%) found in both ovaries, consistent with its metastatic nature. ==historical== krukenberg tumors are named after friedrich ernst krukenberg (1871â1946), who reported what he thought was a new type of primary ovarian malignancy in 1896; six years later these were shown to be of metastatic gastrointestinal tract origin. however, paget had described the process in 1854. ==etiology and incidence== krukenberg tumors can be seen in all age groups, with an average age of 45 years. in most countries, cancer that has metastasized to the ovary accounts for only about 1 to 2% of ovarian cancer; in the remainder, the ovary itself is the primary cancer site. however, in japan they represent a much higher percentage of malignancies in the ovary (almost 20%) due to the increased prevalence of gastric cancer. krukenberg tumors account for about 15% of metastatic cancers that initially appear to have arisen in the ovary, and as such is less common than metastasis arising from ovarian epithelial and germ-cell tumors. in people who have had nongynecologic malignancy, approximately 20% of adnexal masses are malignant, and 60% of these are krukenberg tumors. ==symptoms== krukenberg tumors often come to the attention when they cause abdominal or pelvic pain, bloating, ascites, or pain during sexual intercourse. krukenberg tumors can occasionally provoke a reaction of the ovarian stroma which leads to hormone production, that results in vaginal bleeding, a change in menstrual habits, or hirsutism, or occasionally virilization as a main symptom. all these symptoms are non-specific and can also arise with a range of problems other than cancer, and a diagnosis can only be made following confirmatory investigations such as computed tomography (ct) scans, laparotomy and/or a biopsy of the ovary. ==pathogenesis== there has been debate over the exact mechanism of metastasis of the tumor cells from the stomach, appendix or colon to the o
Gastrointestinal_cancer Ovarian_cancer