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We report PET/CT appearance of bilateral ovarian metastases in a 63-year-old female patient with newly diagnosed poorly differentiated adenocarcinoma of the stomach. She was also found to have peritoneal metastasis on an outside CT study. Staging PET/CT demonstrates not only the hypermetabolic gastric primary tumor and peritoneal disease but also bilateral enlarged, moderately active ovaries. The patient subsequently underwent biopsies of bilateral ovaries which revealed metastatic disease from primary gastric carcinoma. It is important to consider this form of neoplasm in the differential diagnosis because the treatment and prognosis will be different from a dyssynchronous primary tumor.

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