**4. Conclusions**

Association between peritoneal carcinomatosis creating urinary tract obstruction and Krukenberg tumor is an extremely rare eventuality in patients with pulmonary adenocarcinoma. The case we reported presents a series of particularities: the symptomatology at the time of presentation, almost complete dysphagia due to a thoracic mass compressing the esophagus, the modality in which the final diagnostic was established, and laparoscopic adnexectomy in association with peritoneal nodules biopsy, which revealed positive immunohistochemical staining for TTF-1, CK7, and CEA. The demonstration of EGFR, PD-L1, and ALK mutations offered a chance for improved survival for our patient, who thereby became a candidate for immunotherapy.

**Author Contributions:** I.B. performed surgery; N.B. and S.S. performed histopathological and immunohistochemical studies; M.G. advised about oncologic testing; B.M. and S.L. performed the imaging studies; G.T. performed urological procedure; M.C. performed endoscopic evaluation; N.B. performed literature data review; C.C. finally reviewed the manuscript. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors have no conflicts of interest to declare regarding this study.

#### **References**


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