Rare Diagnosis of Krukenberg Tumor: Intrahepatic Cholangiocarcinoma

Krukenberg tumor is a rare ovarian metastatic cancer from the gastrointestinal tract. It accounts for 1%-5% of malignant tumors of the ovaries, usually being bilateral, of solid consistency and may have cystic areas. The World Health Organization (WHO) defined it as an ovarian metastasis when the mucus-secreting cells of “signet ring” are present, associated with sarcomatous stromal proliferation. We present a 58-year-old woman with the diagnosis of peripheric cholangiocarcinoma with ovarian metastasis, showing history of pain and increased abdominal volume. Magnetic Resonance Imaging (MRI) showed multiple hepatic solid nodules with predominantly peripheral, centripetal and progressive enhancement, demonstrating hipersignal and restriction on diffusion weighted imaging (DWI). In the anexial region, bulky heterogeneous multiloculated cystic formations with solid components, of probable ovarian origin, were noted. Biopsy of the liver nodules confirmed the diagnosis of cholangiocarcinoma.