Presentation
Abdominal pain and distention.
Patient Data
Diffuse gastric wall thickening due to tumoural 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 favour of tumoural 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 tumoural 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.
Case Discussion
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 tumour (or carcinoma mucocellulare). The colon and stomach are the most common primary tumours to result in ovarian metastases, followed by the breast, lung, and contralateral ovary. They tend to develop during the reproductive years.