Seventeen-year Survival of a Case of Advanced Gastric Cancer with Krukenberg Tumor Treated by Oophorectomies, Subsequent Gastrectomy, and Chemotherapy

Abstract

A 49-year-old woman visited a clinic with a chief complaint of abdominal fullness. She was referred to our hospital, diagnosed to have an ovarian tumor of approximately 20 cm in size, and underwent hysterectomy with bilateral oophorectomies combined with lymph node dissection. Since metastatic ovarian cancer was suspected on histological examination, she underwent a thorough examination. A gastric cancer was found, and total gastrectomy with splenectomy was performed 4 months after the initial surgery. Finally, advanced gastric cancer with ovarian metastasis was confirmed histologically (pT3, N3, M1 Stage IV). As chemotherapy, paclitaxel and carboplatin were injected 7 times, and S-1 was administered for one year. She has been well without any recurrence for 17 years. Ovarian metastasis from gastric cancer is widely known as a Krukenberg tumor, and its prognosis is dismal, particularly in patients treated first with oophorectomy. There have been a few reports of long-term survival of gastric cancer after resection of a Krukenberg tumor and gastrectomy. It is assumed that no distant metastases except for the ovary, no peritoneal dissemination, no residual tumors after gynecological and gastric surgeries, and chemotherapy are factors related to the long survival of this patient.