Tumeur de Krukenberg: à propos de 5 cas

Krukenberg tumours are rare, often bilateral ovarian malignant tumours secondary to muco-secreting gastric cancer, in 90% of cases. We collected data from patients' medical records over a period of 17years, between January 2002 and January 2019. These patients had Krukenberg tumors for which they were treated in the Department of Hepato-Gastro-Enterology at the Ibn Rochd Hospital University. The purpose of this retrospective, descriptive study was to update the current understanding of this type of neoplasm characterized by poor prognosis, in order to improve diagnostic performance and therapeutic treatment. The average age of our patients was 42 years, ranging between 25 and 61 years. Ascites was the most common manifestation and was reported in 80% of cases. Radiological assessment highlighted ovarian tumor of variable size and echo structure, unilateral in 60% of cases. Oeso-gastroduodenal fibroscopy showed gastric process in 4 patients. Surgical exploration and immunohistochemical examination of biopsic specimens resulted in the correct diagnosis of cancer of the transverse colon with massive locoregional extension and gastric infiltration in one case. The fifth patient underwent exploratory laparotomy which revealed metastatic colonic neoplasia. Radical surgery could be performed only in two patients, in the other two cases only biopsies were performed due to the late stage of the disease. One patient had profoundly altered general state and was at high-risk for anaesthetic, then surgical procedure could not be performed. Only two patients received postoperative chemotherapy. Fatal outcome was reported in 100% of cases. This study reconfirms the catastrophic prognosis of Krukenberg tumor based on its insidious evolution often leading to late diagnosis and to a clear misunderstanding of its etiopathogenesis. We conclude that the improvement of survival chances is based on systematic assessment of ovaries in patients with digestive neoplasia. Some authors also affirm that prophylactic ovariectomy should be performed in women older than 40 years who have undergone gastrointestinal cancer surgery.