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Updated: Jun 16, 2026

Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Case Report: Negative initial endoscopy and 18F-FDG PET/CT may not exclude occult gastric cancer
Zian Jin1, Changhong Dong1, Kou Wang1
1Department of Oncology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China.
None:
Gastric cancer with ovarian metastasis (Krukenberg tumor) can mimic primary ovarian malignancy, creating diagnostic uncertainty. We report a female patient with peritoneal dissemination and bilateral adnexal masses, a presentation initially considered more suggestive of primary ovarian malignancy. However, initial EGD showed no definite gastric mass, and 18F-FDG PET/CT revealed no FDG-avid gastric primary lesion. Peritoneal biopsy revealed metastatic adenocarcinoma with a gastrointestinal-favoring immunophenotype, but repeat EGD was initially deferred due to clinical constraints. Empiric ovarian cancer-directed chemotherapy was started, followed by rapid progression. Repeat EGD later revealed an irregular ulcerative lesion at the gastric angle, and biopsy confirmed gastric adenocarcinoma with focal signet-ring cell components.
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