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A Krukenberg tumor is a metastatic ovarian tumor that typically originates from a primary gastrointestinal (GI) adenocarcinoma, most commonly the stomach, followed by the colon, appendix, or breast.

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It is characterized by the presence of mucin-producing signet-ring cells within the ovarian stroma.

Epidemiology

• Typically affects women aged 30–60
• Can occur in pregnant women
• Often bilateral (in >80% of cases)

Pathology

• Histologically, the tumor contains signet-ring cells with intracytoplasmic mucin displacing the nucleus.
• Named after Friedrich Krukenberg (1896), who initially thought it was a primary tumor.

Primary sources:

• Stomach (especially diffuse-type gastric carcinoma – linitis plastica) – ~70%
• Colon and appendix
• Breast (lobular carcinoma)
• Gallbladder, biliary tract, pancreas

Clinical Features

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Suspect in women with bilateral solid adnexal masses, especially with GI symptoms or known GI cancer.

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• Non-specific abdominal symptoms: pain, bloating, or fullness