A 52-year-old woman presents with bilateral ovarian masses and a recent history of weight loss and early satiety. Both ovaries are enlarged, firm and maintain their overall shape. Histology shows ovarian parenchyma infiltrated by discohesive malignant cells with abundant intracytoplasmic mucin displacing the nucleus to one side. The most likely primary site of this tumour is:

• A Appendix
• B Endometrium
• C Fallopian tube
• D Stomach ✓

Explanation

Krukenberg tumour denotes metastatic mucin-producing signet ring carcinoma involving the ovaries, classically from gastric carcinoma via transcoelomic or haematogenous spread, typically producing bilaterally enlarged ovaries that retain their shape. Signet ring morphology is the defining feature and separates it from other metastases. Appendiceal mucinous tumours cause pseudomyxoma peritonei with gelatinous ovarian deposits but lack signet ring cells as the dominant pattern. Endometrial and tubal primaries produce carcinomas of their respective types, not signet ring Krukenberg morphology.

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.