Krukenberg tumor is a tumor secondary to gastrointestinal carcinoma. Metastasis usually occurs bilaterally, i.e. on both sides. If detected early, a good chance of survival can be achieved with neoadjuvant chemotherapy or radiotherapy including radical surgery. In the advanced stage, the chance is rather small.
What is a Krukenberg tumor?
The symptoms of a Krukenberg tumor are often very subtle and non-specific, especially in the early stages. The diagnosis is therefore very difficult. See AbbreviationFinder for abbreviations related to Krukenberg Tumor.
The secondary Krukenberg tumor, Latin Fibrosarcoma ovarii mucocellulare carcinomatodes, is a form of ovarian metastasis and was named after Friedrich Ernst Krukenberg, who first described it before he died in 1946.
Put simply, a Krukenberg tumor is the metastasis of a gastrointestinal carcinoma in the ovaries or in the Douglas space, which is located between the uterus and the rectum and is also categorized as a drip metastasis (distant metastasis). Metastases develop in body cavities as a result of a caudal migration of detached tumor cells to other organs or organ parts by gravity.
Metastasis is often bilateral, cavitary. The histological picture shows signet ring cells forming mucus. Because the ovarian stroma proliferates, the cells multiply. At around 14 percent, the Krukenberg tumor, which often occurs on both sides, i.e. bilaterally, is the third most common ovarian metastasis. Otherwise the percentage is five to ten percent.
It is believed that the hematogenous spread mainly in the early stages. represents the most likely cause. In addition, the direct spread of the tumor cells into the abdomen by reaching the ovaries can also be a cause. In this case one would have to speak of dripping metastases.
However, since the greater omentum lying between the stomach and ovaries is never affected by metastases, this thesis is considered rather improbable. Another argument against this is that a Krukenberg tumor does not occur on the outside of the ovary, but inside it, the ovarian stroma. Genetic genetic information should not be forgotten as a cause.
Considering that a Krukenberg tumor is a secondary tumor of gastric carcinoma, the causes that can trigger gastric cancer must be considered. These include infections caused by Helicobacter pylori, as well as chronic gastritis (chronic gastritis or pernicious anemia) or heavy nicotine consumption.
A diet high in nitrosamines can also promote Krukenberg tumor. These include beer, smoked, salty or cured foods (meat) and a high consumption of fish and cheese with high nitrosamine levels. In addition, lack of exercise and severe obesity play a not insignificant role in the disease.
However, by no means everyone who suffers from one or more of these symptoms develops stomach cancer. On the other hand, gastric cancer is diagnosed in patients who have never had any of these symptoms before.
Symptoms, Ailments & Signs
The symptoms of a Krukenberg tumor are often very subtle and non-specific, especially in the early stages. The diagnosis is therefore very difficult. Patients often suffer from abdominal pain. These are often located in the lower abdomen.
Furthermore, vaginal bleeding and dyspareunia (painful sexual intercourse) are frequently reported. A changed menstrual cycle is also frequently mentioned. There is also a feeling of fullness and a drop in performance. In the advanced stage, fever, night sweats and unwanted weight loss occur.
The symptoms of a gastric carcinoma should also be taken into account, because the primary tumor can usually be found there, from which the Krukenberg tumor develops as a secondary tumor (foreign tumor). Therefore, in addition to the symptoms mentioned above, it should be observed whether there are tarry stools, dysphagia, nausea and loss of appetite.
Diagnosis & course of disease
Women are particularly affected during the perimenopause or postmenopause. Sometimes the Krukenberg tumor can be palpated in the lower abdomen. An imaging examination using MRI (magnetic resonance therapy) or a laparotomy (surgical intervention) with subsequent histological examination of the tissue provide clarity. Histologically, there are characteristic signet ring cells filled with mucus.
In many cases, the Krukenberg tumor leads to the death of the patient. For this reason, early detection of this tumor is particularly important so that it can be removed and treated in good time. As a rule, the life expectancy of the patient is also significantly reduced by the Krukenberg tumor. The patients primarily suffer from severe weight loss.
Furthermore, pain occurs during sexual intercourse and there is a bloated stomach or a feeling of fullness. It is not uncommon for patients to sweat at night and women suffer more often from vaginal bleeding. The patient’s quality of life is significantly restricted and reduced by the Krukenberg tumor. There is also nausea or nausea.
It is not uncommon for those affected to show swallowing disorders and can no longer normally take in food and liquids. A tar stool also appears. The Krukenberg tumor is treated with radiotherapy or chemotherapy. In many cases, chemotherapy causes various side effects. Whether this will lead to a positive course of the disease cannot usually be predicted in general.
When should you go to the doctor?
Since the Krukenberg tumor develops only in people of the female sex, women or girls belong to the endangered group of people. You should see a doctor as soon as you develop abdominal irregularities that are not related to your menstrual cycle or to an existing pregnancy. If you have pain in the lower abdomen, a pulling feeling when moving or discomfort during the sexual act, a doctor’s visit is advisable. If the pain gradually increases in intensity or extent, see a doctor as soon as possible.
Since the course of the tumor can be life-threatening, a doctor should be consulted at the first indications and symptoms. If inexplicable bleeding occurs, fever sets in or night sweats form on the body, a doctor is needed. If you lose your appetite, lose weight unintentionally, or have abnormal bowel movements, you should see a doctor. Nausea, vomiting, a general feeling of being unwell or a drop in the usual level of performance are other indications that should be followed up.
A doctor should be consulted as soon as the symptoms persist unabated for several days or weeks. Swelling of the body, a feeling of tightness in the abdomen and difficulty swallowing can indicate a discrepancy. A doctor’s visit must be initiated immediately so that medical care can take place.
Treatment & Therapy
Since Krukenberg’s tumor is a secondary tumor of gastric cancer, the first priority is to identify the primary tumor in order to treat it. Therapeutically, neoadjuvant chemotherapy or radiotherapy including radical surgery are available. The ovaries and the affected sections of the intestine are removed.
This therapy is successful when the Krukenberg tumor is limited to the ovaries and the pelvis. If the tumor has already spread, the prognosis is rather unfavorable. Therefore, at the beginning of a therapy (preoperative) there is also the classification, the determination of the tumor stage with the TNM formula.
The exact determination of the existing anatomical extent is the basis for the course of treatment with microscopic examination of the tumor tissue. After removal of the affected tissue and the surrounding edge zones and possibly the lymph nodes, the stage of the resection is determined postoperatively. The result provides information about whether tumorous tissue is still present.
Outlook & Forecast
The prognosis of Krukenberg’s tumor is unfavorable in most cases. Treatment is very complex and requires immediate intervention by a doctor. The disease is a secondary tumor disease, which presupposes that a primary tumor disease is already present in the organism. Without medical treatment, the cancer cells continue to spread unhindered in the body. Ultimately, there is a multiple failure of various functional abilities or organs and thus the premature death of the person concerned.
There is only a prospect of alleviating the symptoms or even healing if the primary and secondary disease can be diagnosed at an early stage. Comprehensive treatment must be initiated as soon as possible. In therapy, it is important to localize the primary tumor and, if possible, to eliminate it completely.
In addition to cancer therapy, surgery is necessary in most cases. If both the primary and the secondary tumor can be completely removed during the operation, the prognosis improves considerably. Nevertheless, there is a risk of additional complications from the procedure and the therapy that has been initiated. In addition, when making the prognosis, it must be taken into account that metastases may have already formed in other places in the organism, leading to the spread of cancer cells.
A healthy and varied diet rich in fiber can prevent this. This includes fresh and gently cooked vegetables. The color palette red as well as yellow and green should be considered. Onions, potatoes and brown rice are also part of the menu.
Fresh fruit, preferably organic, should also be part of your daily diet. Meat and fish, preferably organic, should only be consumed in moderation because of the nitrosamine levels. Healthy organic wholemeal bread (without pesticides) made from rye, spelled, buckwheat or emmer flour stimulates digestion and thus helps to purify and detoxify the body. Limit the consumption of beer.
Sufficient exercise is also important. Going for a brisk walk for at least an hour every day is a good start. It is even better to do a sport extensively two to three times a week so that the organism gets going. Obesity should be strictly avoided as a preventive measure.
In the case of a Krukenberg tumor, aftercare measures are severely limited in most cases or are not available to the person affected at all. The patient is primarily dependent on rapid diagnosis and treatment so that no further complications or symptoms occur. A complete cure is usually not possible, so that the life expectancy of many sufferers is greatly reduced due to the Krukenberg tumor.
Most patients with this disease are dependent on chemotherapy or radiation therapy. They often need the support of their parents or friends. Loving support in everyday life has a very positive effect on the course of the disease. Loving and intensive discussions with those affected are also necessary in order to prevent psychological problems or depression.
After a surgical procedure, the person concerned should definitely rest and protect his body. Efforts or stressful activities should be avoided in order not to unnecessarily burden the body. After the Krukenberg tumor has been removed, regular examinations by a doctor should take place in order to identify and remove further tumors at an early stage.
You can do that yourself
Patients with a Krukenberg tumor can take various measures to relieve symptoms and support medical treatment. Rest and bed rest apply first . In the case of a smaller tumor caused by a comparatively harmless form of cancer, the affected person can continue to work and take part in daily life. In the case of a serious illness, strenuous activities should be avoided.
The individual symptoms can be alleviated by means of the typical measures. Cooling pads and moderate exercise as well as bed rest and relaxation help with fever and chills. If you experience a sore throat or difficulty swallowing, herbal tea with honey is recommended. A proven remedy from homeopathy is Argentum nitricum in the potency D12.
Weight loss, loss of appetite and gastrointestinal complaints require a medical evaluation. At the same time, the diet should be changed. A low-carb, high-fat diet can also help inhibit the growth of cancer cells. Tumor patients should contact their doctor and work out an individual diet together with them. This can not only inhibit tumor growth, but also counteract the individual symptoms. If the measures and means mentioned have no effect, medical advice is required.