[Krukenberg tumor: rare metastasis of hilar cholangiocarcinoma].

Introduction: Hilar cholangiocarcinoma is a rare cancer revealed in this case only after its ovarian metastasis, a Krukenberg tumor.
Case Report: A 60-year old woman was hospitalized for jaundice. Her medical history included a hysterectomy eight months earlier for a Krukenberg tumor. The primary tumor had never been found. Physical examination showed isolated cholestatic jaundice. Blood tests revealed cholestasis and cytolysis. Hepatobiliary ultrasound showed dilatation of the intrahepatic bile ducts. Abdominal computed tomography confirmed that dilatation stopped at the hilar plate. Transparietal cholangiography findings suggested cholangiocarcinoma. Surgery discovered an extensive unresectable tumor of the proximal principal bile duct. The surgeon took tissue samples and placed a T-drain for decompression. The histology study found adenocarcinoma of the bile duct, and concluded that the Krukenberg tumor was secondary to this cholangiocarcinoma.
Discussion: Hilar cholangiocarcinoma quickly invades adjacent structures, such as the liver, gallbladder, lymph nodes, blood vessels and local nerves. Remote metastases have been reported in the lungs, spleen, adrenal gland, and peritoneum. Ovarian metastasis of hilar cholangiocarcinoma is very rare.