Learning objectives
To describe main radiological findings of Krukenberg tumors in computed tomography (CT) and magnetic resonance (MR).
To correlate the characteristics of lesions with the pathophysiology of the process.
Background
Krukenberg tumors are secondary ovarian tumors histopathologically defined as adenocarcinomas that have a significant component (>10% of the tumor) of mucin-filled signet-ring cells and pseudosarcomatous proliferation of ovarian stroma.
This name has sometimes been used incorrectly in the literature,
including all tumors that metastasize the ovaries or to refer to ovaries with metastases from primitive carcinomas of the gastrointestinal (GI) tract exclusively.
The term Krukenberg tumor (KT) was first coined in 1896 by Friedrich Ernst Krukenberg,
who defined it as a primitive ovarian neoplasm of...
Findings and procedure details
1.
Location of the primary tumor
In most cases,
the KT is diagnosed at the same time as the primary neoplasm.
It should be noted that only in 30% of patients is previously known the primitive tumor.
On many occasions,
this low percentage can be explained due to the small size of the primary tumor or from overlooking findings in extrapelvic locations in the CT and MR images.
Therefore a thorough search outside the pelvis is necessary in order to find a possible primitive tumor...
Conclusion
In the case of bilateral complex ovarian masses,
metastatic or serous epithelial tumors should be considered.
In premenopausal women with predominantly solid bilateral ovarian masses,
a possible primitive gastrointestinal tumor should be sought.
The CT and MRI characteristics of ovarian lesions and other intra-abdominal findings are useful to guide the diagnosis of krukenberg tumor.
References
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CT and MR findings ofKrukenberg tumors: comparison with primary ovarian tumors.
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Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the Radiology Diagnostic Oncology Group Study.
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