A 32-year-old female patient at 32 weeks of gestation presented with persistent agonizing epigastric pain with vomiting from conception. CA125 levels were raised and a second look ultrasound scan revealed a viable fetus with a right-sided ovarian mass. Preterm vaginal delivery at 32 weeks resulted in a viable infant. Excision of the ovarian mass revealed Krukenberg tumor (KKT). The other ovary was grossly normal. Ovarian malignancy in pregnancy is a rare phenomenon, more so is the KKT. The infrequency, initial unilaterality, and the low power view misled identification at first. Periodic acid–Schiff and mucicarmine histochemical staining clinched the diagnosis.
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