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Ovarian Metastases, Including Krukenberg Tumor
Priyanka Jha, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Definitions

            • Secondary (metastatic) neoplasms to ovary
            • Krukenberg tumor
              • Subtype of metastatic tumors that contain > 10% mucin-filled signet cells in cellular stroma
              • Usually from gastrointestinal tract with 76% arising from stomach
              • Krukenberg tumor is sometimes used inappropriately by some to include all metastatic ovarian carcinomas
            • High-stage mucinous tumors involving ovary frequently represent metastases from extraovarian primary sites and are often misdiagnosed as primary ovarian mucinous tumors

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Taylor EC et al: Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics. 41(1):289-315, 2021
                                            2. Kato MK et al: Novel classification of ovarian metastases originating from colorectal cancer by radiological imaging and macroscopic appearance. Int J Clin Oncol. 25(9):1663-71, 2020
                                            3. Zulfiqar M et al: Krukenberg tumors: update on imaging and clinical features. AJR Am J Roentgenol. 215(4):1020-9, 2020
                                            4. Jeung YJ et al: Krukenberg tumors of gastric origin versus colorectal origin. Obstet Gynecol Sci. 58(1):32-9, 2015
                                            5. Nakamura Y et al: A Krukenberg tumor from an occult intramucosal gastric carcinoma identified during an autopsy. Case Rep Oncol Med. 2014:797429, 2014
                                            6. Alvarado-Cabrero I et al: Metastatic ovarian tumors: a clinicopathologic study of 150 cases. Anal Quant Cytol Histol. 35(5):241-8, 2013
                                            7. Guerriero S et al: Preoperative diagnosis of metastatic ovarian cancer is related to origin of primary tumor. Ultrasound Obstet Gynecol. 39(5):581-6, 2012
                                            8. Willmott F et al: Radiological manifestations of metastasis to the ovary. J Clin Pathol. 65(7):585-90, 2012
                                            9. Kitajima K et al: FDG PET/CT features of ovarian metastasis. Clin Radiol. 66(3):264-8, 2011
                                            10. Maeda-Taniguchi M et al: Metastatic mucinous adenocarcinoma of the ovary is characterized by advanced patient age, small tumor size, and elevated serum CA125. Gynecol Obstet Invest. 72(3):196-202, 2011
                                            11. Abe Y et al: A case of metastatic malignant melanoma of the ovary with a multilocular cystic appearance on MR imaging. Jpn J Radiol. 27(10):458-61, 2009
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Secondary (metastatic) neoplasms to ovary
                                                      • Krukenberg tumor
                                                        • Subtype of metastatic tumors that contain > 10% mucin-filled signet cells in cellular stroma
                                                        • Usually from gastrointestinal tract with 76% arising from stomach
                                                        • Krukenberg tumor is sometimes used inappropriately by some to include all metastatic ovarian carcinomas
                                                      • High-stage mucinous tumors involving ovary frequently represent metastases from extraovarian primary sites and are often misdiagnosed as primary ovarian mucinous tumors

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Taylor EC et al: Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics. 41(1):289-315, 2021
                                                                                      2. Kato MK et al: Novel classification of ovarian metastases originating from colorectal cancer by radiological imaging and macroscopic appearance. Int J Clin Oncol. 25(9):1663-71, 2020
                                                                                      3. Zulfiqar M et al: Krukenberg tumors: update on imaging and clinical features. AJR Am J Roentgenol. 215(4):1020-9, 2020
                                                                                      4. Jeung YJ et al: Krukenberg tumors of gastric origin versus colorectal origin. Obstet Gynecol Sci. 58(1):32-9, 2015
                                                                                      5. Nakamura Y et al: A Krukenberg tumor from an occult intramucosal gastric carcinoma identified during an autopsy. Case Rep Oncol Med. 2014:797429, 2014
                                                                                      6. Alvarado-Cabrero I et al: Metastatic ovarian tumors: a clinicopathologic study of 150 cases. Anal Quant Cytol Histol. 35(5):241-8, 2013
                                                                                      7. Guerriero S et al: Preoperative diagnosis of metastatic ovarian cancer is related to origin of primary tumor. Ultrasound Obstet Gynecol. 39(5):581-6, 2012
                                                                                      8. Willmott F et al: Radiological manifestations of metastasis to the ovary. J Clin Pathol. 65(7):585-90, 2012
                                                                                      9. Kitajima K et al: FDG PET/CT features of ovarian metastasis. Clin Radiol. 66(3):264-8, 2011
                                                                                      10. Maeda-Taniguchi M et al: Metastatic mucinous adenocarcinoma of the ovary is characterized by advanced patient age, small tumor size, and elevated serum CA125. Gynecol Obstet Invest. 72(3):196-202, 2011
                                                                                      11. Abe Y et al: A case of metastatic malignant melanoma of the ovary with a multilocular cystic appearance on MR imaging. Jpn J Radiol. 27(10):458-61, 2009