Criteria for a Krukenberg tumor:
(1) metastatic adenocarcinoma to the ovary (with exclusion of primary ovarian tumor)
(2) >= 10% signet ring cells
The metastases may be unilateral or bilateral.
Clinical presentation:
(1) abdominal swelling with or without ascites
(2) abdominal pain
(3) abnormal vaginal bleeding
(4) virilization
(5) hirsutism without virilization
Sites of primary tumors include:
(1) appendix
(2) stomach
(3) breast
(4) lung
(5) small intestine
(6) colorectum
(7) gallbladder
(8) urinary bladder
Pathologic features may include:
(1) cystic change, which may be absent in the primary tumor
(2) maturation phenomenon (tumor in the ovary better differentiated than the primary)
(3) a range of microscopic patterns, including microcysts, sheets, nests, cords, glands and tubules
