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The metastatic growths in the ovaries were studied using 361 autopsy cases of carcinoma (except the primary ovarian carcinoma) . The results obtained were as follows. 1) The so-called Krukenberg tumor was defined conveniently as the grossly bulky ovarian tumor with apparent metastasis (metastatic ovarian tumor), irrespective of colloid differentiation. That is, the Krukenkerg tumor is used in a broad sense. Judging from the mode of spread and its biological behavior, the term"metastatic ovarian tumor"should be preferable to the Krukenberg tumor. 2) The Krukenberg tumors were observed in 75 cases (20.7 %) of the 361 female autopsy cases of carcinoma. In 53 cases (36.1 %) of the grossly normal 147 ovaries, microscopic metastases were observed. A number of microscopic metastasis in the ovaries were unilateral, although most of the Krukenberg tumors were bilateral. In cases of unilateral metastasis, metastatic foci were frequently observed in right ovaries both in cases of macroscopic and microscopic metastasis. 3) The Krukenberg tumors were observed in 54 cases (36.7 %) of 147 cases of gastric cancer. Furthermore, microscopic foci in the ovary were revealed in 22 cases (47.8 %) among 46 cases of gastric carcinoma which showed no macroscopic metastasis in the ovaries. In 54 cases (72.0 %) of the 75 cases of Krukenberg tumor, conversely, the primary sites were stomach. So it may well be said that the gastric carcinoma is liable to metastasize in the ovary. 4) Histological features of the stomach which spreads to the ovary, were mostly scirrhous carcinoma or carcinoma simplex. In most of cases (ca. 90 cancer cell infiltration into the gastric serosa and dissemination into the Douglas' cul-de-sac were observed. 5) The Krukenberg tumors occur from 16 to 82 years old (average, 44.7 years old) . The average age of the Krukenberg tumor in cases of the gastric cancer was 41.7 years old and that of the other cancers was 52.4 years old. There was 10 years gap between them. The three fourths of the Krukenberg tumors were found before the climacterium. These findings suggest that there are some important relationship between the tumor metastasis in the ovary and the function of the ovary. 6) It has been said that ovarian hormone has some tendency to promote the growth of the cancer, especially that of the breast cancer. It is possible that the cancer metastasized in the ovary may spread to other organs and tissues more widely. Oophorectomy should be done actively in the female cancer cases before the climacterium. 7) The ovary with metastases are apt to fall into the gelatinous degeneration more frequently and intensely than the primary lesion. The milieu interieur of the ovary seems to give some influences to the cancer cells in the ovary. 8) About the mode of spread, dissemination seems to be the most commonest metastatic path-way to the ovary as far as the primary lesion is concernd in the intraperitoneal organs. In most of 40 cases of microscopic metastasis in the ovary (primary intraperitoneal cancers including gastric cancer), cancer cell infiltration, invasion and adherence to the ovarian surface were observed like mashroom or mooth. In other cases, cancer cell infiltration was only limited in the stroma just beneath the surface of the ovary. These findings strongly suggest that almost all of the Krukenberg tumors of the primary intraperitoneal cancers are formed by dissemination from the primary lesion.
学校法人昭和大学・昭和医学会の論文

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羽山忠良
昭和大学医学部第二病理学教室

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