Ovarian Krukenberg Tumor

Ovarian metastases can account for as many as 30–40% of all ovarian malignancies1–3. The potential for metastatic tumors to mimic the clinical and morphologic appearance of primary ovarian tumors is well known to surgical pathologists2. Correct diagnosis and successful management of patients with these diseases often rely on the degree of distinction between primary and metastatic tumors. Most of the recent literature emphasizes various origins for the tumors metastasizing to malignant ovarian tumors. Ovarian metastatic tumors originating from primary tumors in the gastrointestinal tract are collectively known as the Krukenberg tumors. The most common non-gynecologic primary tumors are frequently observed in the large intestine1,4 or breast5,6. Cholangiocarcinoma or bile duct cancer metastasizing to the ovary is extremely rare. It is readily apparent that its retroperitoneal location and low histologic specificity in the ovary often leads to a misdiagnosis. Limited clinical cases of this disease type make any further attempt in the accurate diagnosis based on clinical, radiologic and morphologic symptoms even more difficult. We present here a rare case of a woman with recurrent cholangiocarcinoma, presenting as an ovarian Krukenberg tumor. It is hoped that this case report can contribute to the understanding of this unusual malignancy.