[Krukenberg tumour: diagnostic findings and surgical therapy. Recent acquisitions]

The authors report on their experience with two cases of Krukenberg's tumour treated at Chioggia Hospital in patients admitted for pelvic tumours. The clinical manifestation of Krukenberg's tumour is mainly related to the presence of the pelvic mass even in advanced forms of gastrointestinal cancers. The authors stress the importance of an adequate follow-up of premenopausal patients with a previous gastrectomy for adenocarcinoma because the incidence of ovarian metastases is quite frequent and influences the prognosis. The Authors do not consider a bilateral preventive ovariectomy associated with gastrectomy as advisable in premenopausal patients, because the studies to date are inadequate for the purposes of drawing conclusions regarding the benefit of these procedures. They consider a more valid policy to be a thorough follow-up in women with a previous gastrectomy for adenocarcinoma because the priority must be accorded to diagnosing secondary lesions so as to be able to perform an ovariectomy which may improve the prognosis. With this in mind it is important to assess Ca 19.9 and perform radiological procedures, such as CT and MRI. The prognosis may be distinctly unfavourable as in one of the cases reported by the Authors involving a very rare form of secondary lesion of the bone marrow and consequent medullary aplasia, with the onset of severe haemorrhages in several areas leading to the patient's death. They consider that surgical treatment should be preceded by a diagnostic laparoscopy. When there are other concomitant negative prognostic factors such as neoplastic ascites and perineal carcinosis, ovariectomy will prove ineffective from the prognostic point of view.