A 42-year-old woman has bilateral solid ovarian masses discovered on evaluation of recent-onset abdominal bloating. Histology of the excised ovaries shows signet ring cells infiltrating a cellular ovarian stroma. Which primary site most commonly gives rise to this pattern of ovarian involvement?
- A Colon
- B Stomach ✓
- C Breast
- D Pancreas
Correct answer: B. Stomach
Explanation
Krukenberg tumour refers to ovarian metastasis containing mucin-filled signet ring cells within a sarcoma-like stromal proliferation, and by definition the commonest primary is gastric adenocarcinoma. Colon, breast, pancreas and gallbladder can all metastasise to ovary, and colonic metastases may mimic primary mucinous tumours, but they typically lack the diffuse signet ring morphology. Bilateral involvement and preservation of normal ovarian shape favour metastasis over a primary ovarian cancer.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.