50 year old woman presented with bilateral solid ovarian tumors, asitis and ulcerative growth in pyloric region of stomach. What is the preferred diagnosis
**Core Concept**
Krukenberg tumors are metastatic deposits to the ovaries, typically originating from a primary malignancy in the gastrointestinal tract, most commonly the stomach. These tumors are characterized by mucin-producing signet-ring cells, which can cause bilateral ovarian enlargement.
**Why the Correct Answer is Right**
The presence of bilateral solid ovarian tumors, ascitis, and an ulcerative growth in the pyloric region of the stomach suggests a diagnosis of gastric carcinoma with Krukenberg tumors. The mucin-producing signet-ring cells in the gastric carcinoma metastasize to the ovaries, resulting in Krukenberg tumors. The ovarian involvement can cause ascitis due to the release of mucin from the tumor cells.
**Why Each Wrong Option is Incorrect**
**Option A:** Ovarian cancer would typically present with unilateral ovarian tumors, and the ascitis and gastric ulcer would not be directly related to the ovarian cancer.
**Option B:** Metastatic disease to the ovaries from a primary malignancy in another location, such as the breast or colon, would not be associated with an ulcerative growth in the pyloric region of the stomach.
**Option C:** Ectopic pregnancy can cause ascitis, but it would not explain the presence of bilateral solid ovarian tumors or the ulcerative growth in the pyloric region of the stomach.
**Clinical Pearl / High-Yield Fact**
Krukenberg tumors are a classic example of metastatic disease to the ovaries, and the presence of signet-ring cells in the ovarian tumors should raise suspicion for a primary gastric malignancy.
**Correct Answer:** C. Metastatic Krukenberg tumors from gastric carcinoma.