A 42-year-old woman has bilateral solid ovarian enlargements discovered during evaluation for recent melena and iron deficiency anaemia. Ovarian histology shows diffuse infiltration by mucin-filled signet ring cells. Which is the most likely primary site?

• A Breast
• B Colon
• C Appendix
• D Stomach ✓

Explanation

Krukenberg tumour is strictly defined as an ovarian metastasis containing mucin-secreting signet ring cells, classically arising from a gastric primary. Colon metastases are more common overall among ovarian metastases but are usually gland-forming rather than signet ring rich, which is the discriminating point. Appendiceal mucinous tumours produce pseudomyxoma peritonei rather than signet ring ovarian deposits, and breast metastases are lobular and lack intracellular mucin signet morphology.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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