Abdominal pain and distention.
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Diffuse gastric wall thickening due to tumoral infiltration is seen predominantly involving the distal portion of body and antrum, accompanied by multiple perigastric enlarged lymph nodes and several omental soft tissue masses in favor of tumoral deposits. There are also several para-aortic lymph nodes with a maximum size of 15mm. The fat plane between the gastric mass and pancreas is obliterated and the pancreas is enlarged at the distal portion suggestive local tumoral invasion.
Small volume ascites.
An IUCD is present within the uterine cavity.
Both ovaries are markedly enlarged and show heterogeneous enhancement. Several enlarged lymph nodes are present in the para-iliac regions.
Bilateral enlargement of ovaries in a known patient with gastric adenocarcinoma (signet ring sub type - pathology proven) in a young female consistent with bilateral ovarian metastasis known as Krukenberg tumor (or carcinoma mucocellulare). The colon and stomach are the most common primary tumors to result in ovarian metastases, followed by the breast, lung, and contralateral ovary. They tend to develop during the reproductive years.
- Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- Ha HK, Baek SY, Kim SH et-al. Krukenberg's tumor of the ovary: MR imaging features. AJR Am J Roentgenol. 1995;164 (6): 1435-9. AJR Am J Roentgenol (abstract) - Pubmed citation