Unravelling an uncommon cause of abdominal pain in a young female: A rare case report

Abstract Krukenberg tumor (KT) is a rare metastatic ovarian tumor, most commonly originating from primary gastrointestinal carcinoma. It accounts for 1%–2% of all ovarian tumors and typically presents in perimenopausal women. However, its occurrence in younger patients is exceedingly rare. We report the case of an 18-year-old female with a 2-month history of abdominal pain. Clinical examination and imaging revealed bilateral adnexal masses, initially suspected to be fibroma or thecoma. Surgical exploration and histopathological examination confirmed the diagnosis of KT. Further investigations, including fluorodeoxyglucose-positron emission tomography-computed tomography and upper gastrointestinal endoscopy, identified a poorly differentiated gastric adenocarcinoma with signet ring cell morphology as the primary malignancy. Diagnosing KT is challenging due to its nonspecific presentation. This case underscores the importance of considering metastatic disease in young patients presenting with bilateral ovarian masses. Early diagnosis through a high index of suspicion and multidisciplinary clinicoradiological correlation is essential for optimal patient management and prognostic evaluation.