Over metastazı (Krukenberg örüntüsü dahil)

Özet

Over metastazları en sık gastrointestinal sistem ve memeden yayılır; mide kaynaklı taşlı yüzük hücreli metastazlar Krukenberg tümörü olarak adlandırılır. Bilateral, solid veya solid-kistik over kitleleri özellikle bilinen primer tümör, peritoneal hastalık ya da eşzamanlı uzak metastaz bağlamında sekonder kökeni akla getirir. Kontrastlı toraks-abdomen-pelvis BT primer odağı, iki overi, peritoneal yüzeyleri, lenf düğümlerini ve diğer metastaz alanlarını tek incelemede haritalar. Over metastazını yeni primer over kanseri sanmak tümörün kökenini ve yayılım örüntüsünü yanlış yorumlatabilir.

Faz ve pencere

Portal tanısal

Solid veya karma bilateral adneksiyel kitlelerin boyanması, gastrointestinal primer kitle/duvar kalınlaşması, karaciğer ve diğer solid organ metastazları, lenfadenopati, asit, peritoneal implant ve omental infiltrasyon araştırılır; toraks dahil edildiğinde akciğer/plevra metastazları da taranır.

Önerilen pencereler: Yumuşak doku (G 400 / M 40), Batın (G 400 / M 50).

BT bulguları

• Her iki overin ayrı ayrı büyümesi veya over parankiminin bilateral solid ya da solid-kistik kitlelerle yer değiştirmesi metastaz olasılığını artırır.
• Mide kaynaklı Krukenberg metastazları görüntülemede genellikle heterojen ve ağırlıklı solid kitleler oluşturur; iç kistik/müsinöz alanlar değişkenlik gösterir.
• Kolorektal metastazlar primer odağın biyolojisine göre daha kistik, nekrotik veya kompleks görünüm alabilir; tüm over metastazları aynı morfolojide değildir.
• Primer mide, kolon, appendiks veya meme lezyonunun kendisi ve bunlara ait bölgesel lenf düğümleri sistematik olarak taranır.
• Peritoneal nodüller, omental kalınlaşma/kek, mezenterik implantlar ve asit eşlik eden yayılımı gösterir.
• Karaciğer, akciğer, plevra, kemik ve retroperitoneal nodal metastazlar hastalık dağılımını tamamlar.
• Over kitlesinin uterustan köken almadığı; over damar pedikülü, parankim dokusu ve karşı overle ilişkisi izlenerek gösterilir.

Normalde

Normal overler uterusa komşu adneksiyel yataklarda seçilebilir; üreme çağında küçük folliküller görülebilir fakat bilateral solid doku yer değiştirmesi, peritoneal nodül ve omental kek beklenmez. Karşı tarafı, over damar pediküllerini ve pelvik periton/omentum yüzeylerini aynı düzeylerde yan yana kıyasla.

Ayırıcı tanı

Primer epitelyal over kanseri

papiller çıkıntılı kompleks kitleler ve yaygın peritoneal implantlar görülebilir; görüntüleme tek başına histolojik kökeni güvenilir biçimde belirlemez.

Bilateral over lenfoması

homojen solid büyüme, eşlik eden yaygın lenfadenopati ve dalak/diğer nodal istasyon tutulumu yardımcıdır.

Over fibromları

çoğunlukla tek taraflı, düzgün sınırlı ve hafif boyanan solid kitlelerdir; bilinen primer ve sistemik metastazlar tipik değildir.

Endometrioma, overin non-neoplastik lezyonları arasında yer alır.

Tubo-ovaryan apse

kalın duvarlı tübal/adneksiyel koleksiyon ve çevre inflamatuvar yağ değişikliği ile öne çıkar; solid tümör nodu veya primer kanser bulgusu yerine enfeksiyon bağlamı aranır.

Tuzaklar

• Bilateralite metastazı destekler ama tek başına kanıtlamaz; primer epitelyal tümörler de iki overi tutabilir ve bazı metastazlar tek taraflı olabilir.
• Krukenberg terimi özellikle taşlı yüzük hücreli metastatik tümör için kullanılır; yalnız BT görünümüyle histolojik tanım yapılmaz.
• Peritoneal tutulumun yokluğu veya primer lezyonun görüntülemede belirgin olmaması metastatik kökeni dışlamaz; bu durumda over kitleleri değerlendirilirken gastrointestinal sistem ve meme gibi potansiyel primer odaklar sistematik olarak taranmalıdır.
• Primer tümörün BT'de belirgin görünmemesi metastatik kökeni dışlamaz; önceki patoloji, ameliyat ve görüntüleme öyküsü önemlidir.

Kendini dene

1. Bilinen mide adenokarsinomu olan hastada iki overde lobüle solid ağırlıklı kitleler ve peritoneal nodüller saptanıyor. En olası yorum nedir?

   • Krukenberg metastazı
   • Primer seröz karsinom
   • Over fibromu
   • Tubo-ovaryan apse
   Cevabı göster

   Krukenberg metastazı. Mide primeri, bilateral solid ağırlıklı over kitleleri ve peritoneal yayılım metastatik over tutulumunu, Krukenberg örüntüsünü destekler. Seröz karsinom mümkün olsa da bilinen mide primeri köken olasılığını değiştirir; fibrom tek taraflı düzgün solid kitle, apse ise inflamatuvar koleksiyon bekletir.

2. İki overde homojen solid büyüme, retroperitoneal ve mezenterik yaygın lenfadenopati, belirgin mide-kolon kitlesi yok. Ayırıcı tanıda hangisi özellikle düşünülmelidir?

   • Over lenfoması
   • Krukenberg metastazı
   • Endometrioma
   • Pedinküllü leiomyom
   Cevabı göster

   Over lenfoması. Bilateral homojen over büyümesinin yaygın nodal hastalıkla birlikteliği lenfomayı öne çıkarır. Krukenberg metastazında primer veya başka metastatik odaklar aranır; endometrioma kistik kan ürünü içerir, leiomyom ise uterusa bağlıdır.

İlgili konular

• Over epitel tümörü ve karsinomatozis
• Pelvik peritoneal karsinomatozis ve implantlar

Kaynaklar

Bu sayfadaki 36 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 5 cümle bu karşılaştırmada düzeltildi (2026-10-08).

1. Fulminant development of a giant pelvic metastasis from microsatellite-stable early-onset sigmoid colon cancer with KRAS and TP53 co-mutations: a case reportpmc.ncbi.nlm.nih.gov
2. Diagnostic and therapeutic challenges of Krukenberg tumors: Case report of an atypical presentation with obstructive renal failurepmc.ncbi.nlm.nih.gov
3. Primary Small Intestinal Adenocarcinoma Presenting as Ovarian Metastasis With Obstructive Symptoms: A Case Reportpmc.ncbi.nlm.nih.gov
4. Bilateral ovarian metastases from gastric signet-ring cell carcinoma in an 18-year-old: a case report and narrative reviewpmc.ncbi.nlm.nih.gov
5. Case Report: Negative initial endoscopy and 18F-FDG PET/CT may not exclude occult gastric cancerpmc.ncbi.nlm.nih.gov
6. Krukenberg tumour in a 46-year-old black African woman with a background of ovarian fibroma- A case report.pubmed.ncbi.nlm.nih.gov
7. Molecular characteristics and metastatic mechanism of patients diagnosed with Krukenberg tumor from gastric cancer.pubmed.ncbi.nlm.nih.gov
8. Bilateral ovarian metastases from gastric signet-ring cell carcinoma in an 18-year-old: a case report and narrative review.pubmed.ncbi.nlm.nih.gov
9. Signet-ring cell carcinoma of the appendix presenting as diffuse uterine involvement: a case report and literature review.pubmed.ncbi.nlm.nih.gov
10. Ovarian Lymphoma and Bone Metastasis Presenting With Paraparesis in an Adolescent: A Case Report.pubmed.ncbi.nlm.nih.gov
11. Swyer syndrome complicated by rapidly progressive invasive ovarian dysgerminoma with bladder and rectal direct invasion: a rare case report.pubmed.ncbi.nlm.nih.gov
12. Gynecologic imaging errors and pitfalls: how to avoid misdiagnosis on pelvic MRI.pubmed.ncbi.nlm.nih.gov
13. Synchronous Vaginal and Liver Metastases in Rectosigmoid Cancer: Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
14. FIGO staging for gestational trophoblastic neoplasia: 2026.pubmed.ncbi.nlm.nih.gov
15. Fertility-Sparing Surgery in Young Women with Ovarian Anaplastic Carcinoma: Two Case Reports and Literature Review.pubmed.ncbi.nlm.nih.gov
16. Hepatosplenic sarcoidosis: A case report and literature review.pubmed.ncbi.nlm.nih.gov
17. Massive gastrointestinal stromal tumor with exophytic growth mimicking pelvic leiomyosarcoma: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
18. Ovarian mesonephric-like adenocarcinoma mimicking serous carcinoma: A case report integrating cytologic, frozen, histological, immunohistochemistry, and molecular analyses.pubmed.ncbi.nlm.nih.gov
19. Ovarian Metastasis from Invasive Lobular Carcinoma of the Breast: A 6-Case Series with Emphasis on Diagnostic Challenges and the Value of Biopsy.pubmed.ncbi.nlm.nih.gov
20. Bilateral ovarian masses, massive ascites, and prior appendectomy: must it be ovarian cancer? --a case report of pseudomyxoma peritonei 24 years after appendectomy.pubmed.ncbi.nlm.nih.gov
21. Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation.pubmed.ncbi.nlm.nih.gov
22. Uncommon Presentation of a Benign Brenner Tumor Mimicking Malignancy: A Case Report.pubmed.ncbi.nlm.nih.gov
23. Massive Ovarian Fibrothecoma Mimicking Advanced Ovarian Cancer in a High-Risk Patient: Diagnostic Challenges and Selective Use of Preoperative Biopsy.pubmed.ncbi.nlm.nih.gov
24. Primary ovarian synovial sarcoma in an adolescent mimicking a germ cell tumor: A case report and diagnostic challenge.pubmed.ncbi.nlm.nih.gov
25. Krukenberg tumor secondary to gallbladder adenocarcinoma: A case report.pubmed.ncbi.nlm.nih.gov
26. MRI characteristics of ovarian metastasis: differentiation from stomach and colorectal cancer.pubmed.ncbi.nlm.nih.gov
27. Primary Neoplasms of the Seminal Vesicles: A Narrative Review of Carcinoma and the Rarer Non-Epithelial and Biphasic Tumours.pubmed.ncbi.nlm.nih.gov
28. Metastatic appendiceal mucinous adenocarcinoma presenting as bilateral ovarian masses mimicking advanced ovarian cancer: a case report.pubmed.ncbi.nlm.nih.gov
29. ESUR female pelvis group approach to cystic female pelvic lesions.pubmed.ncbi.nlm.nih.gov
30. Primary signet ring cell carcinoma of the appendix presenting as gangrenous appendicitis with peritonitis: a case report.pubmed.ncbi.nlm.nih.gov
31. Peritoneal Oligometastasis in Gastric Cancer: Diagnostic Strategies, Patient Selection, and Emerging Therapeutic Approaches.pubmed.ncbi.nlm.nih.gov
32. Executive Summary of the American Radium Society Appropriate Use Criteria for the Management of Peritoneal Carcinomatosis From Different Tumor Origins: Systematic Review and Guidelines.pubmed.ncbi.nlm.nih.gov
33. Benign hemorrhagic mesenteric cyst mimicking peritoneal dissemination in early-stage ovarian clear cell carcinoma: a case report.pubmed.ncbi.nlm.nih.gov
34. Primary Peritoneal Low-Grade Serous Carcinoma in a 16-Year-Old Female: A Case Report.pubmed.ncbi.nlm.nih.gov
35. International Society of Paediatric Surgical Oncology (IPSO) Minimally Invasive Surgery (MIS) Guidelines.pubmed.ncbi.nlm.nih.gov
36. Results of the feasibility study of clinical trials of the new cancer treatment technology Karanahan for patients with advanced breast cancer.pubmed.ncbi.nlm.nih.gov
37. Assessing the reliability of Response Evaluation Criteria In Solid Tumors (RECIST): a systematic review of the factors contributing to inter-observer variability.pubmed.ncbi.nlm.nih.gov
38. International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
39. Intracavity lavage and wound irrigation for prevention of surgical site infection.pubmed.ncbi.nlm.nih.gov
40. Sonographic and Clinicopathological Characterization of Struma Ovarii: A Retrospective Analysis for Enhanced Preoperative Diagnosispubmed.ncbi.nlm.nih.gov
41. When Two Benign Ovarian Pathologies Collide: An Incidental Bilateral Collision Tumour of Mature Cystic Teratoma and Endometrioma.pubmed.ncbi.nlm.nih.gov
42. Management of Patients with Epithelial Ovarian Cancer: A Systematic Comparison of International Guidelines from Scientific Societies (AIOM-BGCS-ESGO-ESMO-JGSO-NCCN-NICE).pubmed.ncbi.nlm.nih.gov
43. Recurrent Malignant Struma Ovarii With Peritoneal Implants Following Prior Thyroid Carcinoma Treatment.pubmed.ncbi.nlm.nih.gov
44. Paratubal Leiomyoma Mimicking Ovarian Malignancy: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
45. A Scoping Review of the Challenges and Future Perspectives in the Use of Alpha-Emitters for Metastatic Ovarian Cancer.pubmed.ncbi.nlm.nih.gov
46. Intravascular Lymphoma Associated with the Female Genital Tract-Diagnostic Considerations, Therapeutic Approaches, and Outcomes.pubmed.ncbi.nlm.nih.gov
47. Left ovarian mass revealing multivisceral lymphoma.pubmed.ncbi.nlm.nih.gov
48. Atypical Pelvic Tumors in Children.pubmed.ncbi.nlm.nih.gov
49. A rare case of ovarian adenomyoma mimicking primary invasive ovarian cancer with a contralateral serous borderline ovarian tumor: A case report and review of the literature.pubmed.ncbi.nlm.nih.gov
50. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Non-proliferative and Proliferative Lesions of the Non-human Primate ( M. fascicularis ).pubmed.ncbi.nlm.nih.gov
51. Sonographic features of tubo-ovarian abscess mimicking an endometrioma and review of cystic adnexal masses.pubmed.ncbi.nlm.nih.gov
52. Non-traumatic lower abdominal pain: ultrasonographic and clinical differential diagnosis.pubmed.ncbi.nlm.nih.gov
53. Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
54. MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space-based Approach.pubmed.ncbi.nlm.nih.gov
55. Pulmonary cryptococcosis mimicking metastatic progression despite systemic disease stability in advanced colon cancer: A case report and literature review.pubmed.ncbi.nlm.nih.gov
56. When Breast Cancer Meets the Uterus: A Quantitative Review of 105 Cases Spanning Four Decades.pubmed.ncbi.nlm.nih.gov
57. Krukenberg tumours: which patients should be considered for surgery?-a narrative literature review.pubmed.ncbi.nlm.nih.gov
58. What is worth knowing about peritoneal metastases in colorectal cancer?pubmed.ncbi.nlm.nih.gov
59. Giant low-grade endometrial stromal sarcoma with extensive sex cord-like differentiation: a case report.pubmed.ncbi.nlm.nih.gov
60. Current Approaches and Emerging Strategies in the Treatment of Peritoneal Carcinomatosis.pubmed.ncbi.nlm.nih.gov
61. Squamous Cell Carcinoma Arising in a Mature Cystic Teratoma of the Ovary Presenting With a Ruptured Sister Mary Joseph Nodule: A Rare Case Report From Northern Tanzania.pubmed.ncbi.nlm.nih.gov
62. Giant bilateral ovarian metastases from small primary pulmonary adenocarcinoma: from dilemma to diagnosis.pubmed.ncbi.nlm.nih.gov
63. Human biomarker navigator.pubmed.ncbi.nlm.nih.gov
64. Special Issue: EACR 2026 Congress: Innovative Cancer Science, 8-11 June 2026.pubmed.ncbi.nlm.nih.gov
65. Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions.pubmed.ncbi.nlm.nih.gov
66. MRI Virtual Biopsy of T2 Hyperintense Breast Lesions.pubmed.ncbi.nlm.nih.gov
67. Radiological Workup of Cystic Neoplasms of the Pancreas.pubmed.ncbi.nlm.nih.gov
68. PET-CT in Clinical Adult Oncology: III. Gastrointestinal Malignancies.pubmed.ncbi.nlm.nih.gov
69. Complications of lymphoma in the abdomen and pelvis: clinical and imaging review.pubmed.ncbi.nlm.nih.gov
70. Variants and Pitfalls in PET/CT Imaging of Gastrointestinal Cancers.pubmed.ncbi.nlm.nih.gov
71. Ovarian cancer staging and follow-up: updated guidelines from the European Society of Urogenital Radiology female pelvic imaging working group.pubmed.ncbi.nlm.nih.gov
72. How to identify early complications in patients undergoing distal gastrectomy?pubmed.ncbi.nlm.nih.gov
73. Multimodal diagnostic strategies and precision medicine in mucinous ovarian carcinoma: a comprehensive approach.pubmed.ncbi.nlm.nih.gov
74. Diagnostic and therapeutic challenges of Krukenberg tumors: Case report of an atypical presentation with obstructive renal failure.pubmed.ncbi.nlm.nih.gov
75. Transvaginal natural orifice transluminal endoscopic surgery for early-stage ovarian cancer and borderline ovarian tumors: a case series.pubmed.ncbi.nlm.nih.gov
76. CD5-positive diffuse large B-cell lymphoma of the uterus: a Case Report with cytologic findings from uterine cavity drainage and literature review.pubmed.ncbi.nlm.nih.gov
77. Incidentally Discovered Ovarian Cancer Combined With Obturator Nerve Schwannoma: A Rare Case Report.pubmed.ncbi.nlm.nih.gov
78. Case Report: Giant hydropic leiomyoma of the uterus presenting as an aggressive abdominopelvic tumor.pubmed.ncbi.nlm.nih.gov
79. Primary Burkitt lymphoma of the breast in a young north African woman: diagnostic challenge and benefit of early intensive chemotherapy.pubmed.ncbi.nlm.nih.gov
80. A Case Report of an Unusual Cause of Abnormal Uterine Bleeding: Primary Cervical Lymphoma Misdiagnosed As Hormonal Dysfunction.pubmed.ncbi.nlm.nih.gov
81. Metastases to the Male Breast: A Systematic Review.pubmed.ncbi.nlm.nih.gov
82. Abstracts of the 16th European Congress of Paediatric and Adolescent Gynaecology † .pubmed.ncbi.nlm.nih.gov
83. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
84. Case Report: Negative initial endoscopy and 18F-FDG PET/CT may not exclude occult gastric cancer.pubmed.ncbi.nlm.nih.gov
85. Primary Small Intestinal Adenocarcinoma Presenting as Ovarian Metastasis With Obstructive Symptoms: A Case Report.pubmed.ncbi.nlm.nih.gov
86. When size misleads: CT attenuation and enhancement characteristics predict benignity in a giant ovarian mucinous cystadenoma.pubmed.ncbi.nlm.nih.gov
87. CT and MR in peritoneal malignancies: pearls and pitfalls at preoperative examination.pubmed.ncbi.nlm.nih.gov
88. Protecting organs-at-risk in cancer therapies through temporary organ displacement: a comprehensive review.pubmed.ncbi.nlm.nih.gov
89. Incidental findings in female pelvis MRI performed for gynaecological malignancies.pubmed.ncbi.nlm.nih.gov
90. Typical and Atypical Imaging Features of Malignant Lymphoma in the Abdomen and Mimicking Diseases.pubmed.ncbi.nlm.nih.gov
91. Ovarian Masses in Children and Adolescents: A Review of the Literature with Emphasis on the Diagnostic Approach.pubmed.ncbi.nlm.nih.gov
92. In Search of an Imaging Classification of Adenomyosis: A Role for Elastography?pubmed.ncbi.nlm.nih.gov
93. Best Practice Recommendations for Infertility Management.pubmed.ncbi.nlm.nih.gov
94. An ultrasound-based machine learning model for predicting pelvic adhesions: A SHAP-enhanced XGBoost approach.pubmed.ncbi.nlm.nih.gov
95. Surgery in Ovarian Cancer-Brazilian Society of Surgical Oncology Consensus.pubmed.ncbi.nlm.nih.gov
96. Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology.pubmed.ncbi.nlm.nih.gov
97. MRI insights into endometrial stromal tumors.pubmed.ncbi.nlm.nih.gov
98. Imaging Evaluation of Ovarian Masses in a Pediatric Population: A Comprehensive Overview.pubmed.ncbi.nlm.nih.gov
99. A Rare Mimicker: Renal Endometriosis and Its Diagnostic Pitfalls-Review of Reported Cases.pubmed.ncbi.nlm.nih.gov
100. ESR Essentials: Gynaecological causes of acute pelvic pain in women: a primer for emergent evaluation-practice recommendations by the European Society of Emergency Radiology.pubmed.ncbi.nlm.nih.gov
101. Decreased attenuation difference between non-contrast and portal-venous phases of CT predicts the ultrasonography-unspecified adnexal torsion.pubmed.ncbi.nlm.nih.gov
102. Cross-sectional imaging of acute gynaecologic disorders: CT and MRI findings with differential diagnosis-part I: corpus luteum and haemorrhagic ovarian cysts, genital causes of haemoperitoneum and adnexal torsion.pubmed.ncbi.nlm.nih.gov

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