Tubular Krukenberg Tumor with an Occult Primary

Tubular Krukenberg tumor with an occult primary can cause problems in histopathologic diagnosis, by mimicking primary ovarian tumors. We present one such occurrence in a 32year old female who underwent surgery for bilateral malignant ovarian tumor. Gross examination of both ovarian tumors revealed bosselated, smooth outer surface with a few cysts on the surface. Cut surface was grey-white to yellowish in colour with cysts filled with serous fluid at the periphery. Microscopic examination revealed mucin laden signet ring cells, predominantly showing tubular architecture within a cellular ovarian stroma. The cytoplasm of these cells varied from granular eosinophilic to pale vacuolated appearance and showed PAS and mucicarmine positive mucin. Differential diagnosis with other primary ovarian tumors is discussed.