Supplementary Material for: Krukenberg tumor of gastric origin in pregnant women with preeclampsia

Krukenberg tumor refers to a malignancy in the ovary that metastasizes from a primary site, classically the gastrointestinal tract. Pregnancy complicated with a Krukenberg tumor is very rare. In this report, we present two unusual cases of pregnant women with Krukenberg tumors of gastric origin. One case was a full-term pregnant woman with preeclampsia (PE) who underwent a caesarean section when bilateral enlarged ovaries were incidentally identified. Histopathology of the wedge resection biopsy showed single-ring cell carcinoma; this was followed by gastroscopy, which indicated a gastric origin. The woman received chemotherapy but died six months later. Another case was a pregnant woman at 30 gestational weeks with abdominal pain complicated with early-onset PE. Ultrasonography and magnetic resonance imaging showed bilateral enlarged ovaries and elevated tumor markers. Gastroscopy indicated linitis plastica. After an emergency caesarean section, adnexectomy was performed, and postoperative histopathology confirmed a Krukenberg tumor. The woman died two months after delivery. Gastrointestinal symptoms during pregnancy may indicate a malignancy of rare gastrointestinal origin. PE complicated with Krukenberg tumors in pregnancy should be considered in future studies.

库肯勃瘤（Krukenberg tumor）指原发灶（典型为胃肠道）转移至卵巢的恶性肿瘤。妊娠合并库肯勃瘤极为罕见。本报告报道2例罕见的妊娠合并胃源性库肯勃瘤病例。一例为足月妊娠合并子痫前期（PE）患者，剖宫产术中意外发现双侧卵巢增大。楔形切除活检的组织病理学检查提示为印戒细胞癌；后续胃镜检查证实其原发灶来源于胃部。该患者接受化疗，但于术后6个月死亡。另一例为孕30周、伴腹痛及早发型子痫前期的孕妇。超声及磁共振成像检查显示双侧卵巢增大，肿瘤标志物水平升高。胃镜检查提示为皮革胃。急诊剖宫产术后行附件切除术，术后组织病理学检查证实为库肯勃瘤。该患者于分娩后2个月死亡。妊娠期间出现胃肠道症状，需警惕罕见的胃肠道来源恶性肿瘤。未来研究中应考虑妊娠合并库肯勃瘤伴子痫前期的可能性。