A gastric metastasis from ovarian carcinoma mimicking GIST - a case report

Ovarian cancer has the highest mortality rate among gynecological malignancies. Metastatic sites are most commonly found in the peritoneum, pelvic organs, and lymph nodes, followed by the liver, distant lymph nodes, lungs, bones, and brain. There have only been a few reports of distant metastases in the stomach. Herein, we present a rare case of a 59-year-old woman with high-grade serous ovarian carcinoma with a single metastasis in the stomach. The post-surgery follow-up was performed with 18F-FDG PET/CT. The patient remained recurrence-free for 3 years. On a routine follow-up PET/CT scan, an intramural hypermetabolic lesion in the stomach, suggestive of GIST, was detected. A biopsy confirmed a metastasis from high-grade serous ovarian carcinoma. A “Reverse Krukenberg” tumor—a gastric metastasis from ovarian cancer—is extremely uncommon. The exact mechanism of spreading to the stomach is still unknown. Even though gastric metastasis from ovarian carcinoma is uncommon, we advise clinicians to stay mindful of the potential for gastric metastasis in patients with a history of ovarian cancer.