卵巢Krukenberg瘤的临床诊治(附20例分析)

Clinical diagnosis and treatment of Krukenberg tumor:Analysis of 20 cases

目的:探讨卵巢Krukenberg(库肯勃)瘤的临床特点、诊断及治疗方法。方法:回顾分析我院2002年6月至2007年12月收治的20例卵巢Krukenberg瘤患者的临床资料。结果:20例患者年龄28～83岁,平均(50±14)岁,多为中青年女性。本组转移灶位于双侧卵巢者13例(65%),单侧者7例(其中右侧5,左侧2例);原发灶病理类型为胃低分化腺癌,部分印戒细胞16例,结肠腺癌3例,乳腺浸润性导管癌1例;同时性转移13例(65%),异时性转移7例(35%,转移时间为6个月至3年)。结论:Krukenberg瘤有其特珠临床特点,易漏诊、误诊;确诊为卵巢恶性肿瘤时应首先排除转移癌的可能;发现卵巢转移肿瘤者,应常规行胃肠道检查以寻找原发灶;手术是卵巢Krukenberg瘤首选治疗方式。

Objective To investigate the clinical feature,diagnosis and treatment of Krukenberg tumor. Methods Clinical and histological data of 20 cases of Krukenberg tumor were analyzed retrospectively. Results Ages of these 20 patients with Krukenberg tumor were 28-83 years, average （50±14） years, mostly were in middle and young age. Krukenberg tumor occurs in bilateral ovaries in 13 cases （65%） and unilaterial in 7 cases （5 cases at right side, 2 cases at left side）. The primary carcinomas were low differentiated gastric adenocarcinoma （16 cases, some were signet ring carcinoma）, colonic ade （3 cases） and infiltrating ductal carcinoma of the breast （1 case）; 13 cases （65%） were synchronous metastasis and 7 cases （35%） were non-synchronous metastasis （6 months to 3 years）. Conclusions Krukenberg tumor has specific clinical characteristics and is hard to diagnosis before operation. Metastatic ovarian tumor should be excluded before establishing the diagnosis of ovarian malignant neoplasm. Patients with metastatic ovarian neoplasm should be routinely examined for searching primary neoplasm. Surgical operation is the first choice of treatment and extent of resection should be determined by the condition of patient.