Krukenberg Tumor

Introduction

• Description: A Krukenberg tumor is a metastatic tumor (generally from the gastrointestinal tract) that is characterized by large signet-ring cells. The most common site of origin is the stomach or large intestine. Named after Friedrich Ernst Krukenberg (1871–1946), who reported the ovarian malignancy in 1896.

• Prevalence: Constitutes 1%–2% of all ovarian neoplasms.

• Predominant Age: Late reproductive to postmenopausal, average age 45 years.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Metastatic spread of carcinoma from the gastrointestinal tract (most commonly the stomach or colon). Metastatic breast cancer may appear similar histologically.

• Risk Factors: None known.

Signs and Symptoms

• Asymptomatic.

• Adnexal enlargement (bilateral solid adnexal masses in an older patient should always suggest the possibility of a gastrointestinal tract source).

• Metastatic tumors from the gastrointestinal tract to the ovary can be associated with sex hormone production, usually estrogen.

Diagnostic Approach