Appearance of Krukenberg tumor from gastric carcinoma, ultrasound and computed tomography evaluation

The Krukenberg tumor is a rare malignant tumor of the ovary, accounting from 1% to 2% of all ovarian tumors. It is usually a bilateral involvement of ovaries from the metastatic deposit from adenocarcinoma of the stomach. We present a patient at the age of 45, who visited a doctor because of pain in the stomach, nausea, and vomiting and weight loss of more than 20 kg. Clinical, biochemical, endoscopic, pathohistological, radiological and imaging studies [ultrasound (US) and computed tomography (CT)] have been performed. The radiological examination was performed using a noncontract and double-contrast technique. The US examination was performed with a 3.75 MHz convex probe, using a standard overview technique. CT was made after oral administration of 700 mL of water, i.v. application of a non-ionic contrast agent of 90 mL in bolus, in hypotonia achieved by i.v. glucagon application, with a scanning width of 10 mm. The radiological finding is in favor of diffuse neoplastic submucosal infiltration of the stomach wall in the region of the corpus and antrum with expressed desmoplastic reaction (linitis plastica). CT findings confirm the radiological findings of the stomach, clearly visualize metastases in the ovaries and peritoneum-ascites, thus diagnosing the primary inoperable neoplastic stomach process—linitis plastica, with metastases in the ovaries—Krukenberg tumor. A comparison of the obtained radiological and imaging results with the endoscopic and pathohistological findings has been made. Krukenberg tumor is an ovarian metastasis of digestive tract cancer. Radiological and especially imaging methods have high diagnostic value and accuracy.