Purpose: To describe the radiological features of Krukenberg Tumors (KT) arising from the pancreas and compare them to KTs originating from gastrointestinal tract.
Materials and methods: The CT studies and clinical records of consecutive women (2011-2017) with pancreatic, colorectal (CRC) and gastric KTs were retrospectively evaluated. CT findings were reviewed in consensus by two radiologists. The CT features for both types of KTs were compared for the following features: unilateral vs. bilateral ovarian involvement, maximal tumor diameter, density (cystic vs. mixed cystic/solid vs. solid) and presence of septations in cystic lesions.
Results: The study sample included 5 pancreatic (4/5 biopsy proven), 11 CRC and 9 gastric KTs. All pancreatic KTs had similar CT characteristics: tumors were bilateral, bulky, averaging 7.5 cm, well-defined, and cystic with internal septations, and with mass effect depending on size. Similar to the pancreatic KT, most cases of non-pancreatic KT were found to be bilateral (p=0.289). Pancreatic KTs were larger than non-pancreatic KTs (pancreatic: 7.5±3.1 cm; CRC: 4.0±1.0 cm; gastric: 4.3±0.9 cm, p<0.001). While all the pancreatic KT were cystic, most non-pancreatic tumors were either purely solid or mixed solid and cystic. Whereas only 1/11 (9.1%) of the CRC KT and 1/9 (11.1%) of the gastric KT were cystic (p<0.001).
Conclusion: Pancreatic KTs appear as large, bilateral, cystic masses with septations, unlike CRC and gastric KTs which are usually smaller and solid or mixed. Findings of bilateral large cystic masses should raise the suspicion of pancreatic KT.
