Krukenberg tumor

Case contributed by Western General Colorectal


Chronic cough and worsening shortness of breath. Expanding abdominopelvic mass over the last 2 months.

Patient Data

Age: 55 years
Gender: Female

Huge abdominal mass clearly visible on examination.

Blood results

  • hypochromic microcytic anemia
  • CEA: 126 (normal 0-5)
  • CA 125: 51 (normal 0-35)

Multiple focal nodular densities throughout both lungs. In the context of suspected malignancy, these are highly suspicious for metastatic disease.


Large hypoechoic heterogeneous multi-lobulated mass within the abdomen. Not hypervascular.


CT confirmed the US finding of a large lobulated intra-abdominal mass and confirmed liver and lung metastases.

Surgery 1 month later:

  • clinical deterioration with pain
  • worsening anemia
  • decompensation of respiratory function

Intra-operative photos


Intraoperative photography demonstrating a large tumor arising from the ovary and a much smaller primary colonic neoplasm.

CT/intra-operative correlation

Annotated image

The large ovarian mass has the expected lobulated pattern. The thickened cecal wall seen on the CT is identified intra-operatively.

Case Discussion

Krukenberg tumor (carcinoma mucocellulare)

  • metastatic ovarian adenocarcinoma from different primary tumor sites
  • gastric carcinoma is the commonest primary tumor (~50% of Krukenberg tumors)
  • T4 colonic adenocarcinoma have potential for transcoelomic spread to the ovaries
  • discrimination between primary and metastatic ovarian tumors is important

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