A lady with abdominal mass was investigated. She was found to have bilateral ovarian masses with smooth surface. On microscopy they revealed cells with signet ring shapes. Diagnosis is-
## **Core Concept**
The question tests knowledge of ovarian tumors, specifically those with a signet ring cell morphology. Signet ring cells are a type of malignant cell often associated with certain types of carcinomas. In the context of ovarian pathology, these cells are characteristic of Krukenberg tumors.
## **Why the Correct Answer is Right**
Krukenberg tumors are metastatic tumors to the ovaries, typically originating from a primary site such as the stomach (gastric carcinoma). These tumors are known for their signet ring cells, which are mucin-filled, malignant cells that push the nucleus to the periphery, resembling a signet ring. The presence of bilateral ovarian masses with a smooth surface and signet ring cells on microscopy strongly supports the diagnosis of Krukenberg tumors. This condition often presents with ovarian enlargement and may mimic primary ovarian neoplasms.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is not provided, but typically, incorrect options might include other types of ovarian tumors such as mucinous cystadenocarcinoma, serous cystadenocarcinoma, or granulosa cell tumors. These do not characteristically present with signet ring cells.
- **Option B:** Similarly, without the specific content of Option B, one might guess it could represent another type of metastatic or primary ovarian tumor not characterized by signet ring cells.
- **Option C:** Again, without specifics, this could represent a distractor such as a different type of carcinoma or sarcoma not associated with signet ring morphology.
- **Option D:** This option is also unspecified but presumably is another incorrect diagnosis.
## **Clinical Pearl / High-Yield Fact**
A crucial point to remember is that Krukenberg tumors are metastatic to the ovaries, most commonly originating from gastric carcinoma. The presence of signet ring cells is pathognomonic. Clinicians should always consider the possibility of metastatic disease when encountering bilateral ovarian masses, and thorough investigation for a primary site is warranted.
## **Correct Answer:** D. Krukenberg tumor.