# Recurrence of gastric cancer with Krukenberg tumor, presenting with a high alpha-fetoprotein level, a case report

## TL;DR

A rare case of gastric cancer spreading to the ovaries with unusually high alpha-fetoprotein levels is reported, highlighting the importance of considering uncommon patterns in cancer evaluation.

## Contribution

This case report presents a rare instance of gastric cancer with ovarian metastasis and elevated AFP, expanding understanding of its unusual biological behavior.

## Key findings

- A 30-year-old female presented with gastric adenocarcinoma metastasizing to the ovaries.
- The patient exhibited a significant elevation in serum alpha-fetoprotein levels.
- The case underscores the need to consider rare metastatic patterns and tumor marker profiles in gastric cancer management.

## Abstract

Gastric cancer is a common malignancy globally, often presenting with advanced disease and a propensity for metastasis. While peritoneal dissemination and liver involvement are frequent metastatic sites, ovarian metastasis, particularly Krukenberg tumors, represents a less common but significant manifestation, typically associated with a poor prognosis. The presence of elevated tumor markers, such as carcinoembryonic antigen (CEA) and CA19-9, is often indicative of advanced disease. However, the elevation of Alpha-fetoprotein (AFP) in gastric cancer, a marker more commonly associated with hepatocellular carcinoma or germ cell tumors, is exceedingly rare and suggests an unusual biological behavior or specific histological subtypes. This case report details the presentation of a 30-year-old female patient with gastric adenocarcinoma that metastasized to the ovaries, characterized by a significant elevation in serum AFP levels. This case highlights the critical need to consider uncommon metastatic patterns and unusual tumor marker elevations during the comprehensive evaluation and management of gastric cancer patients.