A 50 year old woman is presenting with bilateral solid ovarian tumors and has ascitis. Upper gastro-intestinal endoscopy reveals an ulcerative growth in pyloric region of stomach. The most likely diagnosis is:
The patient in this question having bilateral solid ovarian tumors with ulcerative growth in pyloric region of stomach is suffering from carcinoma of stomach with krukenberg's tumor. Krukenberg's tumors account for 30-40% of metastatic cancers to the ovaries, they arise in the ovarian stroma and has mucin filled signet ring cells. They are classically described as bilateral ovarian masses arising from metastatic mucin secreting gastric or colon adenocarcinoma. Less commonly it arise from the breast or biliary tract. It is often associated with ascites. The likely cause is considered as fixation and entrance of seeded cells at sites of ovarian follicular rupture and perigonadal fat milky spots. In MRI, the most characteristic finding is that of varied hypointense solid components from a dense desmoplastic reaction. Ref: Harrison's Principles of Internal Medicine, 17th Edition, Page 605 ; Meyers' Dynamic Radiology of The Abdomen: Normal and Pathologic Anatomy By Moon A. Meyers, 6th Edition, Page 104 ; Berek and Novak's Gynecology, Issue 935, Volume 2007 By Jonathan S. Berek, 14th Edition, Page 1527
Malignant ovarian tumor
Carcinoma in the small intestine
Carcinoma body uterus
Carcinoma stomach with Kurkenberg's tumor