Abstract
We present a case of metastatic signet ring cell adenocarcinoma of bone marrow with radiologically proven bilateral ovarian masses in a 50 year old Asian Indian female. Even after thorough search no extraovarian primary site could be found. Based on overall clinicopathologic correlation, a diagnosis of metastatic signet ring cell adenocarcinoma of bone marrow with uncertain primary was established.
Highlights
Marrow metastases in nonhematologic tumors are reported in virtually all types of malignancies
There are only few case reports in the literature describing bone marrow metastasis from primary as well as secondary krukenberg tumors of the ovary (Table 1) [3,4,5,6,7,8]
From review of clinical and autopsy material, the most common occurrence of marrow metastases in nonhematologic malignancies is in patients with carcinomas arising in the prostate, breast, lung, and neuroblastoma [1]
Summary
Marrow metastases in nonhematologic tumors are reported in virtually all types of malignancies. We describe a case of bilateral ovarian masses, histopathology of which could not be done due to early demise of the patient, with metastatic signet ring cell carcinoma in the bone marrow. Based on all the findings a possibility of metastatic signet ring cell carcinoma of bone marrow and Krukenberg tumor with uncertain primary was kept. Bone marrow aspirate and biopsy revealed metastatic signet ring cell adenocarcinoma with near total replacement of normal bone marrow elements. Based on all these findings a diagnosis of metastatic signet ring cell adenocarcinoma was established and advised to search for the primary site. It was assumed that bone marrow metastasis would have been occurred either due to occult primary site in the GIT or to poorly differentiated mucinous carcinoma or primary Krukenberg tumor of the ovary. Differentiated mucinous carcinomas show foci of typical signet ring
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