A 55-year-old woman presents with fatigue and malaise which has been worsening over the last 2 months. She also noticed loss of appetite and early satiety. Evaluation finds an ulcerative mass located along the lesser curvature of the stomach along with bilateral ovarian masses. Which of the following is this patient most likely to have

**Core Concept**
Krukenberg tumors are a type of metastatic cancer to the ovaries, typically originating from a primary site in the gastrointestinal tract. In this case, the ulcerative mass in the stomach suggests a possible primary site, which is a common association with Krukenberg tumors.

**Why the Correct Answer is Right**
Krukenberg tumors are characterized by mucin-filled signet-ring cells in the ovarian stroma, which is a result of metastasis from a primary adenocarcinoma. The presence of an ulcerative mass in the stomach along the lesser curvature, combined with bilateral ovarian masses, is highly suggestive of gastric adenocarcinoma with metastasis to the ovaries, a classic presentation of Krukenberg tumors.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the clinical presentation described.
**Option B:** While ovarian cancer can present with bilateral masses, the presence of an ulcerative mass in the stomach along the lesser curvature is not typical for ovarian cancer.
**Option C:** Metastasis to the ovaries from other primary sites such as colorectal, breast, or lung cancer can occur, but the specific combination of symptoms and findings in this patient makes Krukenberg tumors the most likely diagnosis.

**Clinical Pearl / High-Yield Fact**
Krukenberg tumors often present with a "honeycomb" or "chicken fat" appearance on imaging due to the presence of mucin-filled signet-ring cells in the ovarian stroma.

**Correct Answer:** D.

✓ Correct Answer: A. Krukenberg tumor