EURORAD ESR

Case 13015

Bilateral symmetrical adnexal masses - think Krukenberg!!

Author(s)
Rishi Philip Mathew, Ram Shenoy Basti, Hadihally B. Suresh

Father Muller Medical College,
Father Muller Charitable Institutions,
Department of Radio-Diagnosis;
Father Muller Road
575002 Mangalore, India;
Email:dr_rishimathew@yahoo.com
 
Patient
female, 38 year(s)
 
 
  • Figure 1
    Transabdominal ultrasound of the pelvis
     

    Transabdominal ultrasound of the pelvis (axial section) showed bilateral adnexal heterogeneous solid masses with minimal internal vascularity on Doppler. The ovaries could not be seen seperately.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Transabdominal ultrasound of the stomach using curvilinear and high resolution linear probes showed gastric wall thickening (blue arrows).

     
    Area of Interest: Stomach; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    CT abdomen and pelvis
     

    Post-contrast axial CT porto-venous phase showed a distended stomach with circumferential thickening (3.4 cm) of the wall of the antro-pyloric region.

     
    Area of Interest: Stomach; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Reformatted coronal CT image showed a distended stomach with circumferential thickening of the wall of the antro-pyloric region for a length of 7.3 cm.

     
    Area of Interest: Stomach; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    CT abdomen and pelvis
     

    Plain CT of the pelvis showed bilateral bulky adnexal masses (blue arrows).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Post-contrast CT of the pelvis porto-venous phase showed symmetric, bilateral heterogenously enhancing bulky adnexal masses measuring 6.9 x 4.8 and 6.7 x 4 cm.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Histopathology

    Microscopic evaluation of the ovarian specimen showed "Signet ring" cells confirming the diagnosis of Krukenberg tumour.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Experimental; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Transabdominal ultrasound of the pelvis (axial section) showed bilateral adnexal heterogeneous solid masses with minimal internal vascularity on Doppler. The ovaries could not be seen seperately.
 
Transabdominal ultrasound of the stomach using curvilinear and high resolution linear probes showed gastric wall thickening (blue arrows).
 
Post-contrast axial CT porto-venous phase showed a distended stomach with circumferential thickening (3.4 cm) of the wall of the antro-pyloric region.
 
Reformatted coronal CT image showed a distended stomach with circumferential thickening of the wall of the antro-pyloric region for a length of 7.3 cm.
 
Plain CT of the pelvis showed bilateral bulky adnexal masses (blue arrows).
 
Post-contrast CT of the pelvis porto-venous phase showed symmetric, bilateral heterogenously enhancing bulky adnexal masses measuring 6.9 x 4.8 and 6.7 x 4 cm.
 
Microscopic evaluation of the ovarian specimen showed "Signet ring" cells confirming the diagnosis of Krukenberg tumour.
 
 
 
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