title: Bilateral and multinodular signet-ring stromal tumor of the ovary.
abstract: BACKGROUND
  Signet-ring stromal tumor of the ovary is a rare, benign sex cord stromal tumor that is typically unilateral. Its distinction from malignant signet-ring cell adenocarcinoma metastatic to the ovary (Krukenberg tumor), is critical.
  
  
  METHODS
  A 69-year-old gravida 5 woman presented with a 1-week history of right lower abdominal pain. Ultrasonography revealed a 4-cm right adnexal mass. Serum CA 125 and carcinoembryonic antigen were within normal limits. An exploratory laparotomy, partial omentectomy, bilateral salpingo-oophorectomy and peritoneal washing were performed. Solid multinodular masses in both ovaries were identified that histologically corresponded to bilateral signet-ring stromal tumors.
  
  
  CONCLUSIONS
  We report a rare example of signet-ring stromal tumor that is bilateral and multinodular mimicking a Krukenberg tumor. Awareness of this unusual presentation can help prevent incorrect diagnosis.
authors.affiliation: From the Grand Rapids Medical Education and Research Center; Gynecologic Oncology of West Michigan, the Department of Pathology, Spectrum Health, and West Michigan Gynecologic Oncology, Grand Rapids, Michigan.
authors.forename: Gareth K
authors.initials: GK
authors.lastname: Forde
authors.forename: Charles
authors.initials: C
authors.lastname: Harrison
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Doss
authors.forename: Aviane E
authors.initials: AE
authors.lastname: Forde
authors.forename: Jay W
authors.initials: JW
authors.lastname: Carlson
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007725:Krukenberg Tumor / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D018312:Sex Cord-Gonadal Stromal Tumors / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery