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1、XieYanhuaXieyanhua,bed38,female,40yearsold,wasborninFuyang,Anhuiprovince.Thepatientwasadmittedtoourdepartmentforgastriccancerformorethan2yearsandpelvicmetastasisformorethan10months.Thepatientwastreatedatthepeople'shospitalofTaihecountyfor"sixyearsofabdominalpainandeig
2、htdaysofmelena",OnMay28,2014.SheunderwentradicaloperationofgastriccanceratthePeople’sHospitalofTaiheCountyonJune,2014.Thepathologyreport:Gastriculcertypeadenocarcinoma,partiallysignet-ringcellcarcinoma,invadingmuscularlayer,sizeof3cmx3cm;theupperandlowermarginnegative
3、;4of10lymphnodespositivearoundlessercurvatureand3of3lymphnodespositivearoundgreatercurvature.Aftertheoperation,thepatientunderwent6coursesofPCFregimenchemotherapyinthishospital,whichisnotclearenough.Thepatientwasadmittedtoradiotherapyandchemotherapydepartmentofourhosp
4、italonDecember14th,2016forpelvicmassaftergastriccancersurgery.CA199wasslightlyelevatedinthelocalhospital,andtherewasnoobviousabnormalityinCEAandCA125,butthelesionwasnotclear.PET-CTexaminationshowedanastomoticrecurrence,peritonealseeding,gastroscopyandpathology:notumor
5、cellswerefound.Giventhepatient'spreviousgastriccancerpathologyreport,shewastreatdewith1courseofDFregimen.ThenthepatientwasadmittedtotheFirstAffiliatedHospitalofAnhuiMedicalUniversityBecauseofpelvicmassformorethan9months.Thensheunderwentbilateraluterineappendagesresect
6、ionundergeneralanesthesiaonAugust10,2017.Intraoperativepresentation:uteruspregnancy2monthssize,normalmorphology,serosalsurfacesmooth,rightovarysolidlobulatedincrease,thesizeof15x12x10cm,smoothsurface,theleftovarysolidlobulatedincreased8x6x4cm,smoothsurface,bilateraltu
7、balnormalinappearanceandsmoothappearanceofnormalpelvicfloor.Pathologyreport:(doubleovary)sizewas8.5x5x4cmand14x13x8cm,microscopy,immunohistochemicalstaining,andclinicalhistorywereconsistentwithmetastaticpoorlydifferentiatedadenocarcinoma(Krukenbergtumor).Immunohistoch
8、emistry:CK(+),CK7(+),CEA(+),SMA(-),Desmin(-),CA125(-),alpha-inhibin(-),Vin(-),Ki-67(+,around20%).Forthesakeoffurthertreatmen
