Ovarian primary or secondary: cracking the nut

Ovarian cancer is one of the commonest gynecological cancers and ranks among the top five deadliest cancers in most countries. Tumors of the ovary are majority of the time primary with a small percentage of secondary malignancy. Metastasize to the ovaries can occur from many organs, including the stomach, small intestine, colon, rectum, gall bladder, appendix, pancreas, breast, uterus, fallopian tube, and peritoneum. Stomach is the primary site in 70% of cases. Carcinomas of colon, appendix, and breast are the next most common primary sites. These are referred to as Krukenberg tumor, accounting for 1% to 2% of all ovarian tumors. We report a case of 40 year old female presenting with bilateral solid and cystic ovarian tumor with small primary tumor located in sigmoid colon. The case report highlights the importance of preoperative workup needed to search for primary tumor, as Krukenberg’s tumors are known for poor outcome