Figure 13.30. Krukenberg tumours—ovarian metastases from colonic carcinoma.
(a) Coronal T1W1, (b) coronal T2W1 and (c) transaxial T2W1 show bulky heterogeneous metastatic tumour masses arising from both ovaries (straight arrows). These are intermediate signal on T1W1 and intermediate/high signal on T2W1. Signet ring cell tumours arising from the gastrointestinal tract, particularly the stomach but also from the colon as in this case, may metastasise to the ovaries and are known as Krukenberg tumours. Note also the tumour infiltration of the uterus (curved arrows in (a) and (b)) producing abnormal low signal on T2W1, increased size and irregular margins. Bladder (B).
(a) Transaxial and (b) sagittal T2W1 showing an enlarged, bulky low signal uterus (straight arrows), with foci of high signal metastatic tumour (asterisk) within the myometrium. Note the normal, preserved, high signal endometrial stripe.
(a) Sagittal T2W1 and (b) post-Gd T1W1 showing a large heterogenous metastatic tumour (T), arising from the left adnexa and lying in the Pouch of Douglas pushing the bladder and uterus forwards (straight arrows). After intravenous contrast medium injection, there is enhancement of the mass periphery (curved arrows) but the centre does not enhance due to central necrosis. Uterus (U); bladder (B); rectum (R).
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