Behind the Mask: A Comprehensive Study of Ovarian Signet Ring Carcinoma—Case Report and Literature Review

Primary signet ring carcinoma of the ovary is a rare entity. It is often a diagnosis of exclusion.

A 27-year-old woman presented with abdominal pain and weight loss. Pelvic examination revealed bilateral ovarian masses. The surgical intervention included laparotomy, peritoneal fluid cytology, supracolic omentectomy, hysterectomy with bilateral salpingo-oophorectomy, recto-sigmoidectomy, and removal of bulky lymph nodes, pelvic and parietal peritonectomy, diaphragmatic stripping, and appendicectomy with end colostomy was performed. Gross and microscopic examination confirmed a bilateral Krukenberg tumor, yet the primary source remained elusive despite thorough investigation.

At the 16-month follow-up, the patient remains in good health with no recurrence and is currently undergoing chemotherapy.

Distinguishing the Krukenberg tumor with an occult primary from a primary ovarian tumor is crucial to avoid suboptimal treatment.