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Krukenberg tumor

Case contributed by Prashant Mudgal
Diagnosis almost certain

Presentation

Carcinoma of the stomach for 1 year. Follow up scan.

Patient Data

Age: 40 years
Gender: Female
ultrasound

Two solid masses measuring 18 x 9.5 cm and 9.1 x 5.8 cm are noted in the right and left adnexa respectively.

These two masses appear heterogeneous in echotexture predominantly solid with cystic areas (typical moth eaten cysts).

There is vascularity noted within both lesions.

The ovaries are not seen separately from the lesions.

Moderate free fluid is seen in the abdomen and pelvic cavity.

Case Discussion

The term Krukenberg tumor refers to metastatic disease to the ovary and more specifically those metastases containing mucin-secreting signet cells. Most of these tumors arise in the gastrointestinal tract although the term Krukenberg tumor has also been used more loosely to describe metastatic disease to the ovary from other sites such as breast and genital tract. On ultrasound examination, the Krukenberg tumor has been described as a complex type of mass showing both solid and cystic characteristics. When a mass with these sonographic characteristics is found on pelvic sonography, it is important to consider this entity in the differential diagnosis 1.

The absence of residual disease after treatment and limited disease extent were favorable prognostic factors of metachronous Krukenberg tumor of stomach origin 2.

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