Gastrointestinal surgery: Krukenberg tumour: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: Krukenberg tumour

Sample item

A 38-year-old woman has abdominal distension. Imaging shows bilateral solid ovarian masses that preserve the ovarian shape. Histology shows mucin-filled signet-ring cells in a cellular stroma. Where is the most likely primary tumour?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Stomach

Bilateral ovarian metastases containing signet-ring cells are a Krukenberg tumour. The stomach is the commonest primary, followed by colon, appendix and breast. Spread is by transcoelomic or lymphatic routes, and the finding indicates advanced disease.

Option by option

  • A. Uterine endometrium

    Endometrial cancer usually spreads to the ovary directly or as a synchronous primary, with endometrioid histology and not signet-ring cells.

  • B. Uterine cervix

    Cervical cancer is usually squamous and seldom metastasises to the ovaries.

  • C. Urinary bladder

    Bladder cancer rarely metastasises to the ovaries and is usually urothelial in type.

  • D. Stomach (correct)

    Correct. Gastric signet-ring adenocarcinoma is the commonest source of Krukenberg tumours.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Stomach. Bilateral ovarian metastases containing signet-ring cells are a Krukenberg tumour.

Why is "Uterine endometrium" not the answer?

Endometrial cancer usually spreads to the ovary directly or as a synchronous primary, with endometrioid histology and not signet-ring cells.

Why is "Uterine cervix" not the answer?

Cervical cancer is usually squamous and seldom metastasises to the ovaries.

Why is "Urinary bladder" not the answer?

Bladder cancer rarely metastasises to the ovaries and is usually urothelial in type.

What concept does this question test?

It tests Gastrointestinal surgery: Krukenberg tumour in General Surgery. The stomach is the commonest primary, followed by colon, appendix and breast. Spread is by transcoelomic or lymphatic routes, and the finding indicates advanced disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: Krukenberg tumour?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.