A Case of Gastrointestinal Krukenberg Tumor Initially Suspected as Primary Ovarian Cancer and the Implications for Management

Krukenberg tumors are an uncommon metastatic malignancy most commonly originating primarily from the gastrointestinal tract, particularly the stomach, colon, and/or rectum. Due to the rarity of these malignancies, most patients are believed to have primary metastatic ovarian malignancy instead. Here, we present the case of a patient who was presumed to have ovarian metastatic cancer; however, pathology results showed that the malignancy was gastrointestinal primary in nature. In this instance, intraoperative findings and immunohistochemical profiling played a crucial role in differentiating a Krukenberg tumor with a gastrointestinal primary versus ovarian metastatic cancer. In this case, proper diagnosis resulted in a change of management, highlighting that even the most unlikely differentials should still be considered.