Secondary ovarian tumors: spectrum of CT and MR features with pathologic correlation

The ovaries represent common sites for metastatic disease. The common primary sites for metastatic disease to the ovaries include the colon, stomach, breast, and the genitourinary tract. Hematologic malignancies, including lymphoma and leukemia, also involve the ovaries. Ovarian metastasis may occasionally represent the initial manifestation of disease, especially in cancers of the gastrointestinal tract. The accurate diagnosis of this condition is always crucial since the misinterpretation of such tumors may cause significant adverse consequences for patients. CT and MR features of secondary ovarian tumors differ according to the origins of the primary malignancies. The great majority of metastases from gastric cancer are Krukenberg tumors, which are typically bilateral and characterized by lobulated solid tumors. Metastases from colon cancer are usually cystic tumors with solid components of variable size. Metastases from appendiceal tumor may present as ruptured mucinous ovarian tumors associated with pseudomyxoma peritonei. Metastatic tumors from breast cancer are characterized by the relatively small size of the lesion. Ovarian involvement by hematologic malignancies is typically bilateral, homogeneous solid masses. Recognition of radiologic features of a variety of secondary ovarian tumors is beneficial for suspecting the secondary tumors under certain clinical conditions, and thus determining the appropriate management of the patients.