Krukenberg tumors: CT features and growth characteristics

We reviewed the computerized tomographic features of pathologically proven metastases to the ovary in 12 patients. Serial CT scans were available in nine of the 12 patients--before removal of the ovaries in five cases (showing typical growth characteristics of these metastases) and afterward in six (showing common patterns of tumor progression). Primary neoplasms metastasizing to the ovary included adenocarcinoma of the colon (seven), stomach (two), appendix (one), and endometrium (one), and carcinoid tumor (one). On CT, metastases to the ovary were large lobulated or oval masses with cystic and solid components. Nine were bilateral and three were unilateral. Three patterns of ovarian enlargement were seen: macrocystic (six), microcystic (three), and predominantly solid enlargement with necrosis (three). Other associated CT findings included carcinomatosis, hydronephrosis, ascites, liver metastases, and lymphadenopathy. The primary tumor in patients without a prior history of malignancy was identifiable retrospectively on CT in four of the five cases.