Computed tomography of Krukenberg tumors

Computed tomography (CT) of three patients with Krukenberg tumor was reviewed retrospectively. CT showed large, lobulated, multicystic masses with soft-tissue components, indistinguishable from primary ovarian carcinoma. Indeed, CT and sonography of all three patients were initially interpreted as primary ovarian carcinoma. The ovary is a frequent site of metastases, particularly from colon carcinoma. These can be quite large, yet diagnosis is seldom made preoperatively. Much has been written about metastatic ovarian tumor, but this is the first report in the radiologic literature about their CT features. The authors emphasize the importance of recognizing the ovary as a frequent site of metastases and the proper approach to this problem. In patients with a history of colon or gastric carcinoma, the mixed cystic and solid ovarian mass on CT should be regarded as metastatic tumor until proven otherwise. A careful search for gastrointestinal tract signs or symptoms should be done in any patient with a pelvic tumor. When CT is done for evaluation of ovarian tumor, the stomach and colon should be carefully evaluated, and the ovaries routinely examined in the preoperative CT staging of gastric or colon carcinoma.
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