Maternal Mortality Resulting from Signet-ring Cell Carcinoma of the Sigmoid Colon Presenting as Bilateral Krukenberg Tumours: A Case Report

Abstract

Krukenberg Tumours (KTs) during pregnancy are extremely rare, difficult to diagnose, and have a grave prognosis. Authors hereby, report an autopsy case of a 23-year-old primigravida at 29 weeks of gestation who presented at a tertiary care centre with preterm labour. She complained of severe abdominal pain, backache, and vaginal leakage for the past two days. Physical examination revealed an oedematous abdominal wall and a gravid uterus measuring 34 weeks, as the tumours could not be palpated separately. She underwent a normal vaginal delivery and delivered a live female foetus weighing 1.6 kg. However, she developed septicaemia and, on the fifth postnatal day, progressed to loss of consciousness and subsequently died. A complete autopsy was performed. Her past medical history indicated that at 20 weeks of gestation, bilateral ovarian masses were detected and biopsied. The biopsy revealed high-grade metastatic adenocarcinomas that were positive for CK20 and Epithelial Membrane Antigen (EMA) but negative for CK7, Alpha fetoprotein (AFP) and CD10, suggesting a primary tumour in the gastrointestinal tract. The autopsy revealed a signet-ring cell carcinoma of the sigmoid colon, along with bilateral large KTs and peritoneal metastasis.

Keywords

• autopsy
• colonic cancer
• metastasis
• ovarian cancer
• pregnancy