[Krukenberg syndrome in metastatic gallbladder adenocarcinoma with unknown primary tumor]

The casuistic describes a female patient, in whom a metastatic adenocarcinoma of the ovary was diagnosed 3 years after cholecystectomy due to cholecystolithiasis, which was compatible with metastases of a carcinoma of the gallbladder or the bile ducts. While clinical and imaging results suggested a primary ovarian carcinoma with inapparent primary tumor, the final diagnosis was obtained on the basis of histological findings. The case demonstrates that an ovarian metastasis can simulate a primary tumor according to clinical and imaging results. This fact can be of serious therapeutic consequences for the respective patient. Therefore, in the presence of a clinically inapparent primary tumor, the differential diagnosis of unclear ovarian masses should include metastatic adenocarcinoma in addition to primary ovarian carcinoma and other ovarian lesions.