Krukenberg tumours: diagnosis challenges, treatment approaches, and survival, sixteen-year experience at a single tertiary women’s hospital

Krukenberg tumours are rare metastatic ovarian tumour that originates primarily from the gastrointestinal tract. This study aimed to describe the diagnosis, treatment options, and survival outcomes in women with Krukenberg tumours treated in a single tertiary women’s hospital over a 16-year period. The case series included 15 patients diagnosed with Krukenberg tumours from 2008 to 2024. Data on pre-operative abdominal ultrasound and computed tomography scans, medical history, intraoperative history, treatment options, and laboratory parameters were collected from the hospital’s electronic database. None of the patients were preoperatively diagnosed with Krukenberg tumours, while 11 patients were suspected during surgery. Collaborating with gastroenterologists, oncologists, and pathologists confirmed these diagnoses as metastatic, with the primary sites identified. The other four patients with a history of gastrointestinal tumours (diagnosed 9 to 29 months prior) presented with gynaecological symptoms and were preoperatively diagnosed with primary ovarian tumours. However, Krukenberg tumours were confirmed intraoperatively in these cases as well. The primary tumour originated in the stomach for 10 patients and the colorectal region for 5 patients. Seven patients underwent cytoreductive surgery, while seven others underwent either a hysterectomy and bilateral salpingo-oophorectomy or bilateral salpingo-oophorectomy alone. One patient received palliative care. The median overall survival of all patients was 12 months, while the mean overall survival was 15 months. Among patients who underwent cytoreductive surgery, the median survival was 12.5 months, and the mean survival was 15 months. Pre-operative misdiagnosis of Krukenberg tumours is common. However, active collaboration with gastroenterologists, oncologists, and pathologists during surgery can help gynaecological oncologists overcome these diagnostic challenges.