What is Kruckenberg metastasis? This pathology is secondary cancer. Only the female population is affected, because it is found in the ovaries. It is an accumulation of atypical cells that divide and form a secondary tumor. Among ovarian malignancies , it occupies the third place after the epithelial and embryonic forms of cancer. It serves as an unfavorable sign, reporting the spread of primary malignancy and 3-4 degrees of the process.
Causes
Kruckenberg cancer is metastatic ovarian cancer. Metastasis circulates from the organs of the abdominal cavity, most often the stomach. In rare cases, the mammary gland, thyroid gland, or uterus can serve as the primary focus.
Pathology development mechanisms
The primary tumor becomes an active pathological focus, which is supplied with blood and provided with nutrients. At the same time, the cells divide uncontrollably and can bud. Often they do not get into the circulatory and lymphatic systems of the body. With the flow of these physiological fluids, the malignant cells spread to other organs and secondary tumors develop. Kruckenberg metastasis is more often localized in both ovaries. The tumor begins to progress and serve as a source of new metastases.
There are 4 stages of the oncological process:
- Stage 1 - one ovary is affected.
- Stage 2 - one or both ovaries and the surrounding pelvic fiber are involved in the process.
- Stage 3 - a tumor is found in one or both ovaries, and there are also metastases on the peritoneum of the pelvis or retroperitoneal lymph nodes.
- Stage 4 - cancer covers both ovaries and serves as a source for new metastases to other organs.
Metastases of Virchow, Kruckenberg, Schnitzler and sister Joseph in gastric cancer
Virchow metastasis - spreads with a lymphatic flow through the thoracic lymphatic duct and is localized in the left supraclavicular region. It is well felt during inspection.
Kruckenberg metastasis is localized in the ovaries. Schnitzler metastasis is located in the tissue of the pelvis and is palpated with a digital examination of the rectum. Sister Joseph's metastasis is located in the navel.
Symptoms and treatment of Kruckenberg metastasis
Kruckenberg metastasis is located in the ovaries, which are endocrine organs that produce hormones. Failure is occurring. A change in the hormonal background is manifested by a number of symptoms:
- decreased libido and inability to experience an orgasm (frigidity);
- increased sweating;
- mood swings;
- the appearance of male-type hair growth (the appearance of antennae, hair on the abdomen, chest, back) and a change in the timbre of the voice to a lower one;
- menstrual irregularities (menstruation can be heavy or scanty, extraordinary spotting from the vagina is observed);
- often, tumor aggression provokes the onset of menopause.
A woman can also experience discomfort and pain in the lower abdomen, which disturb at rest or during intercourse, as well as on the eve of menstruation. In some cases, there is a violation of the urination process and a disorder manifests itself in the form of cystitis. A tumor can compress surrounding organs. The degree of symptoms depends on the size of the tumor, age, general condition of the woman and the presence of concomitant pathology.
The listed symptoms are necessarily accompanied by manifestations of primary cancer.
With oncological pathology of the stomach, symptoms are observed:
- belching with a putrid odor;
- nausea and vomiting;
- heaviness in the stomach;
- bloating;
- epigastric pain;
- ascites is an accumulation of fluid in the abdominal cavity.
When the process goes to the peritoneum, it begins to produce a liquid, the volume of which can reach up to 10 liters. It can be found in the pleural cavity, which is manifested by respiratory and cardiovascular failure.
Any cancer process leads to the depletion of the body, because it requires an enhanced fight of the immune system with it, and also requires energy supply of nutritional resources for its growth.
Symptoms of cancer cachexia (exhaustion)
The following symptoms exist:
- general weakness, fatigue;
- an increase in body temperature in the range of 37.3-37.5 degrees;
- significant loss of body weight in a short period of time;
- loss of appetite or lack thereof;
- taste perversion;
- digestive upset.
Diagnosis of Kruckenberg metastasis
Very often, the identification of distant metastases precedes the detection of gastric cancer. In this case, the process can proceed already in the advanced stage (3-4). main diagnostic methods:
- Identify complaints and study the history of the disease. It is necessary to detail the symptoms when it started, what it is connected with, whether there are other symptoms from the gastrointestinal tract.
- Inspection Gynecological examination using mirrors, bimanual examination (with two hands). You can find rounded formations with a smooth surface and painless. The mammary glands and regional (nearby lymph nodes) must be examined. Finger examination of the rectum to detect Schnitzler metastasis.
- Ultrasound examination of the pelvic organs with a filled bladder, the appendages are better visualized. It allows you to quickly determine the pathological focus, its shape, size and degree of spread. There is an ultrasound method with a biopsy.
- Percutaneous biopsy and subsequent cytological examination describing Kruckenberg metastasis. Now it is rarely used, because it is impractical and traumatic.
- MSCT with contrast. Allows you to study in detail the tumor and the surrounding tissue, to determine the presence of metastases. Used with an unclear ultrasound picture.
- The study of the primary focus: fibrogastroduodenoscopy, examination of the mammary glands, ultrasound of the abdominal cavity, examination of the thyroid gland.
- Doppler study of the tumor is necessary to study the blood flow of the tumor. A valuable method for surgeons.
- Determining blood tumor markers - tumor-associated antigens. Their level increases with the progression of the oncological process. The most informative are C-125, CA-19-9, CA-72-4. They are found in 89-100% of patients.
Kruckenberg metastasis treatment
The scope of treatment is determined by the oncologist or surgeon oncologist. It is necessary to take into account the patient's age, severity and stage of the disease. If the patient is contraindicated in the operation, they resort to chemotherapy and radiation therapy, as well as the elimination of the pain syndrome with narcotic analgesics (palliative therapy).
Surgical treatment is very difficult and difficult for the patient, because it is carried out in several stages.
- Elimination of the primary lesion with surrounding fiber and lymph nodes. If this is the removal of the stomach, then the end stage of such an operation will be the application of a gastrostomy.
- Removal of the ovaries. Childbearing age is not taken into account, because the question is about the life of the patient. If only one ovary is affected, then the second is removed for prophylaxis, because the appearance of Kruckenberg metastasis in it is only a matter of time.
Remote organs are sent for histological examination in order to understand the nature of the tumor, the origins of its growth.
After surgical treatment, a course of chemo- and radiation therapy is prescribed to prevent re-neoplasm and to combat the remaining malignant cells in the body.
Rehabilitation of patients after treatment is aimed at psychological assistance, conducting immunostimulating therapy, restorative treatment, adherence to diet, sleep and rest. If there is a gastrostomy, proper care is required. During this period, the support of loved ones is especially important.
Forecast
Unfortunately, disappointing. According to medical statistics, mortality in the first year of morbidity is 95%. But there are cases of five-year survival - 1% of patients. The reason for such harsh statistics is due to the neglected state of the primary malignant lesion.
Kruckenberg metastasis prophylaxis
In our country, the mentality of citizens does not allow timely access to medical care. Our medicine is mostly free, but there are medical examination rooms. Clinics actively invite the attached population to undergo a medical examination. It is aimed at all segments of the population and allows you to identify signs of the initial stages of the disease and timely start treatment. Scheduled examinations by a gynecologist also reveal abnormalities in the female body. In people suffering from diseases of the stomach, it is necessary to conduct routine fibrogastroduodenoscopy, because there is a risk of developing stomach cancer.
Secondary ovarian cancer can be prevented only by regular examination of your body.