Neoplasia: metastasis to the ovary: practice question

A Pathology 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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Pathology · Neoplasia: metastasis to the ovary

Sample item

A 40-year-old woman has bilateral solid ovarian masses. Histology shows mucin-filled signet-ring cells scattered in a cellular, spindle-cell stroma. Which is the most likely primary site?

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

The answer and the reasoning

C. Stomach

A Krukenberg tumour is a metastasis of mucin-secreting signet-ring adenocarcinoma to the ovaries, most often from the stomach. Spread is by transcoelomic or lymphatic routes, and the lesions are frequently bilateral with a prominent reactive stroma.

Option by option

  • A. Uterine cervix

    Cervical squamous carcinoma seldom involves the ovaries and does not form signet-ring cells.

  • B. Kidney

    Renal cell carcinoma has clear cells and rarely metastasises to the ovaries as a mucinous signet-ring tumour.

  • C. Stomach (correct)

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

  • D. Thyroid

    Thyroid carcinomas do not form mucin-filled signet-ring deposits in the ovaries.

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 Pathology question

What is the answer to this Pathology question?

The best answer is C, Stomach. A Krukenberg tumour is a metastasis of mucin-secreting signet-ring adenocarcinoma to the ovaries, most often from the stomach.

Why is "Uterine cervix" not the answer?

Cervical squamous carcinoma seldom involves the ovaries and does not form signet-ring cells.

Why is "Kidney" not the answer?

Renal cell carcinoma has clear cells and rarely metastasises to the ovaries as a mucinous signet-ring tumour.

Why is "Thyroid" not the answer?

Thyroid carcinomas do not form mucin-filled signet-ring deposits in the ovaries.

What concept does this question test?

It tests Neoplasia: metastasis to the ovary in Pathology. Spread is by transcoelomic or lymphatic routes, and the lesions are frequently bilateral with a prominent reactive stroma.

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 Neoplasia: metastasis to the ovary?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.