A communication disorder is any disorder that affects an individuals ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. The delays and disorders can range from simple sound substitution to the inability to understand or use ones native language. Diagnosis
Disorders and tendencies included and excluded under the category of communication disorders may vary by source. For example, the definitions offered by the American Speech–Language–Hearing Association differ from those of the Diagnostic Statistical Manual 4th edition (DSM-IV).Gleanson (2001) defines a communication disorder as a speech and language disorder which refers to problems in communication and in related areas such as oral motor function. The delays and disorders can range from simple sound substitution to the inability to understand or use ones native language. In general, communication disorders commonly refer to problems in speech (comprehension and/or expression) that significantly interfere with an individuals achievement and/or quality of life. Knowing the operational definition of the agency performing an assessment or giving a diagnosis may help.Persons who speak more than one language or are considered to have an accent in their location of residence do not have a speech disorder if they are speaking in a manner consistent with their home environment or that is a blending of their home and foreign environment. DSM-IV
According to the DSM-IV-TR, communication disorders are usually first diagnosed in childhood or adolescence, though they are not limited as childhood disorders and may persist into adulthood. They may also occur with other disorders.
Krukenberg tumors are most commonly metastases from gastric cancer, particularly adenocarcinoma, or breast cancer particularly invasive lobular breast carcinoma, but they can arise in the appendix, colon, small intestine, rectum, gallbladder, and urinary bladder or gallbladder, biliary tract, pancreas, ampulla of Vater or uterine cervix.Immunohistochemistry may help in diagnosing Krukenberg tumors from primary ovarian neoplasms but needs to be applied with discretion. For example, tumors that are immunoreactive to CEA or cytokeratin 20 (CK20) and negative for cytokeratin 7 (CK7) may be more likely to be of colorectal origin. Treatment and prognosis
Since Krukenberg tumors are secondary (metastatic), management might logically be driven by identifying and treating the primary cancer. The optimal treatment of Krukenberg tumors is unclear. The role of surgical resection has not been adequately addressed but if metastasis is limited to the ovaries, surgery may improve survival. The role of chemotherapy and/or radiotherapy is uncertain but may sometimes be beneficial. History
Krukenberg tumors are named after Friedrich Ernst Krukenberg (1871–1946),  who reported what he thought was a new type of primary ovarian malignancy in 1896;  six years later these were shown to be of metastatic gastrointestinal tract origin. However, Paget had described the process in 1854. References
External links

00498 at CHORUS