1
|
Chen M, Liao S, Cao Y, Mao M, Jia X, Zhang S, Xu Y. Benign Brenner tumor of the ovary: two-dimensional and contrast-enhanced ultrasound features-a retrospective study from a single center. Front Oncol 2024; 14:1337806. [PMID: 38525416 PMCID: PMC10959004 DOI: 10.3389/fonc.2024.1337806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/08/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Benign Brenner tumor (BBT) is a rare ovarian tumor, and there are few discrete reports about its manifestation in an ultrasound. This study sought to investigate the two-dimensional (2D) and contrast-enhanced ultrasound (CEUS) features of this entity. Methods This is a retrospective single-center study. The clinical manifestations, laboratory examination, and ultrasound data of 25 female patients with BBT were confirmed by pathology when they underwent 2D and/or CEUS examination at Ningbo First Hospital from January 2012 to June 2023. The ultrasound findings of the patients were analyzed using the terminology of the International Organization for the Analysis of Ovarian Tumor and were read by two senior sonographers who reached an agreement. Results Among the all 25 patients, most of them were unilateral, and only one patient was bilateral. Thus, 26 lesions were found: 44.0% (11/25) were in the left and 52.0% (13/25) were in the right. Moreover, 53.84% (14/26) were solid lesions, 15.38% (4/26) were mixed lesions, and 26.92% (7/26) were cystic lesions. Among the solid-type patients, 42.85% (6/14) of the cases were with calcification. Upon laboratory examination, 12.0% (3/25) of the patients had high carbohydrate antigen 125 (CA-125) level, and 19.04% (4/21) of the patients had an elevated carbohydrate antigen724 (CA-724) level in the serum tumor markers. In the hormone test, 14.28% (3/21) were found to have a high postmenopausal estrogen level and 14.28%(3/21) were found to have a high level of follicle-stimulating hormone (FSH). One patient with complex manifestations and three with solid manifestations were examined by CEUS to observe the microcirculation perfusion of the tumor. One with solid and cystic separation was rapidly hyperenhanced and cleared, and the filling subsided faster than the uterus. The postoperative pathological diagnosis was benign Brenner tumor with mucinous cystadenoma. The other three cases were solid adnexal lesions, which showed isoenhancement on CEUS and disappeared slowly, synchronizing with the uterus. The CEUS results were considered as benign tumors and confirmed by pathology. Conclusions BBT can show ovarian cystic, mixed cystic and solid type, and solid echo in 2D ultrasound. Unilateral ovarian fibrosis with punctate calcification is an important feature of BBT in 2D ultrasound. However, for solid adnexal masses and mixed cystic and solid masses with unclear diagnosis, if CEUS shows isoenhancement or hyperenhancement, the possibility of BBT cannot be excluded.
Collapse
Affiliation(s)
- Mei Chen
- Department of Ultrasonography, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Shusheng Liao
- Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yong Cao
- Department of Ultrasonography, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Meiya Mao
- Department of Gynecology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Xiupeng Jia
- Department of Histology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Shengmin Zhang
- Department of Ultrasonography, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Youfeng Xu
- Department of Ultrasonography, Ningbo First Hospital, Ningbo, Zhejiang, China
| |
Collapse
|
2
|
Ayyanar P, Mitra S, Imaduddin M, Muduly DK. Invasive micropapillary carcinoma of the breast and bilateral ovarian mature cystic teratoma with benign Brenner tumor in a postmenopausal woman - An uncommon occurrence. INDIAN J PATHOL MICR 2024; 67:189-191. [PMID: 38358219 DOI: 10.4103/ijpm.ijpm_1207_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The synchronous occurrence of bilateral ovarian tumors and breast malignancy often raise the suspicion of a Krukenberg tumor or a hereditary breast and ovarian cancer syndrome, both of which are uncommon in clinical practice. A 58-years-old postmenopausal woman had a right breast lump and was diagnosed as infiltrating duct carcinoma, no special type, and incidentally detected bilateral adnexal mass with the clinical suspicion of Krukenberg tumor. However, following the radical surgical excision of the right breast and bilateral ovaries, the right breast showed invasive micropapillary carcinoma (IMPC) while the ovaries showed mature cystic teratoma (MCT) with benign Brenner tumor. IMPC of the breast along with bilateral ovarian MCT with benign Brenner tumor is an unusual clinical occurrence in a postmenopausal female and thus worthy of documentation. It should be categorized as a non-hereditary synchronous tumor. The histomorphology augmented by immunohistochemistry and appropriate clinical context is pivotal in rendering a correct diagnosis.
Collapse
Affiliation(s)
- Pavithra Ayyanar
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Suvradeep Mitra
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Mohammed Imaduddin
- Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Dillip K Muduly
- Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| |
Collapse
|
3
|
Yu Q, Zhao Q, Su Y, Xiong K, Lu Y, Zhang L, Fang H. Borderline Brenner tumor with abnormally high serum level of carbohydrate antigen 199: a rare case report and literature review. Ir J Med Sci 2023; 192:2071-2075. [PMID: 36409423 DOI: 10.1007/s11845-022-03203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
Ovarian Brenner tumor with abnormally increased serum carbohydrate antigen 19-9 (CA19-9) level is extremely rare. A 70-year-old woman with abnormally elevated serum CA199 (1289 U/ml) found in routine physical examination. Pelvic CT and MRI scan revealed a large mass with large patches of calcification in the right adnexal area, and the patient achieved total hysterectomy and bilateral adnexectomy. Grossly, the right ovary had a solid enlargement of about 7.0 cm × 6.0 cm × 5.0 cm with irregular nodules and smooth surface and the cut surface of the mass showed that the tumor is cystic and solid. Microscopically, the tumor showed a background of fibrous tissue hyperplasia with nested and adenoid cell clusters with uniform cell size and clear boundaries. The cells were translucent with eosinophilic cytoplasm and calcification. Immunohistochemical staining showed CK7, CA125, and P63 presented diffusely strongly positive staining, while negativity for CK20, GATA3, AR, P53, and CgA. Ki-67 showed weak positive staining, about 1%. The serum CA199 level decreased significantly on the 5th day after surgery. Postoperative pathology and immunohistochemistry confirmed borderline Brenner tumor. This is the first to report a case of borderline Brenner tumor with an abnormally high serum level of CA199 before surgery. In clinical practice, the possibility of ovarian Brenner tumor should be considered when abnormal elevation of serum CA199 level cannot be reasonably explained.
Collapse
Affiliation(s)
- Qianwei Yu
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Qian Zhao
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yuan Su
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Kangwei Xiong
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yan Lu
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Lijiu Zhang
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Haiming Fang
- Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China.
- Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China.
| |
Collapse
|
4
|
Shang J, Lei T, Wu L, Lin M, Xie H. Comparison of performance between O-RADS, IOTA simple rules risk assessment and ADNEX model in the discrimination of ovarian Brenner tumors. Arch Gynecol Obstet 2023; 308:961-970. [PMID: 37186266 DOI: 10.1007/s00404-022-06903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/20/2022] [Indexed: 05/17/2023]
Abstract
PURPOSE To describe the clinical and sonographic features of ovarian benign Brenner tumor (BBT) and malignant Brenner tumor (MBT), and to compare performance of four diagnostic models in differentiating them. METHODS Fifteen patients with BBTs and nine patients with MBTs were retrospectively identified in our institution from January 2003 and December 2021. One ultrasound examiner categorized each mass according to ovarian-adnexal reporting and data system (O-RADS), international ovarian tumor analysis (IOTA) Simple Rules Risk (SR-Risk) assessment and assessment of different neoplasias in the adnexa (ADNEX) models with/without CA125. Receiver operating characteristic curves were generated to compare diagnostic performance. RESULTS Patients with MBT had higher CA125 serum level (62.5% vs. 6.7%, P = 0.009) and larger maximum diameter of lesion (89 mm vs. 43 mm, P = 0.009) than did those with BBT. BBT tended to have higher prevalence of calcifications (100% vs. 55.6%, P = 0.012) and acoustic shadowing (93.3% vs. 33.3%, P = 0.004), and lower color scores manifesting none or minimal flow (100.0% vs. 22.2%, P < 0.001). Areas under curves of O-RADS, IOTA SR-Risk and ADNEX models with/without CA125 were 0.896, 0.913, 0.892 and 0.896, respectively. There were no significant differences between them. CONCLUSION BBTs are often small solid tumors with sparse color Doppler signals, which contain calcifications with posterior acoustic shadowing. The most common pattern of MBT is a large multilocular-solid or solid mass with irregular tumor borders, and most were moderately or richly vascularized at color Doppler. These four models have excellent performance in distinguishing them.
Collapse
Affiliation(s)
- JianHong Shang
- Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-Sen University, Zhongshan Er Road 58#, Guangzhou, 510080, Guangdong, China
| | - Ting Lei
- Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-Sen University, Zhongshan Er Road 58#, Guangzhou, 510080, Guangdong, China
| | - LiHong Wu
- Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-Sen University, Zhongshan Er Road 58#, Guangzhou, 510080, Guangdong, China
| | - MeiFang Lin
- Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-Sen University, Zhongshan Er Road 58#, Guangzhou, 510080, Guangdong, China
| | - HongNing Xie
- Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-Sen University, Zhongshan Er Road 58#, Guangzhou, 510080, Guangdong, China.
| |
Collapse
|
5
|
Alloush F, Bahmad HF, Lutz B, Poppiti R, Recine M, Alghamdi S, Goldenberg LE. Brenner Tumor of the Ovary: A 10-Year Single Institution Experience and Comprehensive Review of the Literature. Med Sci (Basel) 2023; 11. [PMID: 36810485 DOI: 10.3390/medsci11010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
Brenner tumors (BTs) are surface-epithelial stromal cell tumors that are categorized by the World Health Organization as benign, borderline, and malignant. Due to the rarity of BTs, the published literature on these tumors is comprised primarily of case reports and small retrospective studies. We performed a pathology database review spanning the last ten years at our institution revealing nine reported benign BTs. We collected the clinical and pathological data of patients associated with those BTs, describing the clinical presentation and imaging results, and assessing the possible risk factors associated with them. The average age at diagnosis was 58 years. BTs were discovered incidentally in 7/9 cases. The tumor was multifocal and bilateral in 1/9 cases and ranged in size from 0.2 cm to 7.5 cm. Associated Walthard rests were found in 6/9 cases and transitional metaplasia of surface ovarian and/or tubal epithelium was found in 4/9 cases. One patient had an associated mucinous cystadenoma in the ipsilateral ovary. Another patient had an associated mucinous cystadenoma in the contralateral ovary. In conclusion, we found that Walthard rests and transitional metaplasia are common findings in association with BTs. Additionally, pathologists and surgeons need to be aware of the association between mucinous cystadenomas and BTs.
Collapse
|
6
|
Yadav A, Pujani M, Singh K, Chauhan V, Singh A, Sharma JC. Synchronous Occurrence of Adult Granulosa Cell Tumor with Fibroma in One Ovary and Brenner Tumor in Other Ovary: An Extremely Unusual Case. J Midlife Health 2023; 14:56-59. [PMID: 37680372 PMCID: PMC10482026 DOI: 10.4103/jmh.jmh_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/12/2023] [Indexed: 09/09/2023] Open
Abstract
Ovarian tumors are a common form of neoplasia in women and it accounts for about 30% of female genital cancers. A coexistence of ovarian tumors with the same histogenetic origin such as germ cell or epithelial or sex cord stromal, but different histologic subtype is relatively common, whereas a synchronous occurrence of tumors with different histogenetic origin is rare. We report a case of 58-year-old woman with the synchronous presentation of adult granulosa cell tumor with fibroma (ovarian tumors with the same origin (sex cord stromal) but different histologic type) in one ovary and Brenner tumor (epithelial origin) in other ovary. Our patient presented with postmenopausal bleeding and was diagnosed with this rare combination of ovarian tumors on histopathology supplemented with immunohistochemistry. On extensive literary search, there is only a single report of mixed ovarian tumor composed of Brenner tumor and adult-type granulosa cell tumor. Our case is different from the above-mentioned report as although, in our patient both tumors coexisted, but in contralateral ovaries.
Collapse
Affiliation(s)
- Alka Yadav
- Department of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Mukta Pujani
- Department of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Kanika Singh
- Department of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Varsha Chauhan
- Department of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Aparna Singh
- Department of Pathology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Jagadish Chandra Sharma
- Department of Obstetrics and Gynaecology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| |
Collapse
|
7
|
Fujita T, Takeya A, Miyata H, Ninomiya F, Nonoyama Y, Nakazawa T, Furuya Y, Enoki Y, Fujii T, Fukao S. Thoracic spinal metastasis as recurrence of borderline Brenner tumor without local recurrence: A case report. Gynecol Oncol Rep 2022; 44:101120. [PMID: 36589509 PMCID: PMC9797606 DOI: 10.1016/j.gore.2022.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Background Brenner tumor is a rare epithelial ovarian neoplasm that accounts for 2-3% of all ovarian neoplasms. Herein, we report the first case of thoracic spinal metastasis of recurrent Brenner tumor without local recurrence.Case Description.A 70-year-old female presented with a feeling of abdominal distension. Computed tomography revealed cystic lesions in her bilateral ovaries. Blood examination revealed high CA-125 [74.9 U/ml]. We excised bilateral ovaries, uterus, and omentum. Borderline Brenner tumor was diagnosed [Ki-67 labeling index: 10 %]. Follow-up abdominal echo and CA-125 examination revealed no local recurrence. 26 months later she developed paraplegia. Magnetic resonance imaging revealed tumor in the 5th-9th thoracic vertebra and compression of spinal cord at the 6th thoracic vertebra level. Her paraplegia was progressive. We performed semi-urgent partial resection of tumor and release of spinal cord compression. Spinal metastasis from Brenner tumor was diagnosed [Ki-67 labeling index: 50-60 %]. She received adjuvant radiation of 30 Gy in 10 fractions to the 4th-10th thoracic vertebra. After radiation and rehabilitation, she was discharged home on foot. She received adjuvant radiation and chemotherapy but died 11 months after spinal surgery. An autopsy has not been performed on her, and the cause of death is unknown. Conclusion We report the first case of thoracic metastasis of recurrent Brenner tumor without local recurrence.
Collapse
Affiliation(s)
- Tomoaki Fujita
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan,Corresponding author.
| | - Aya Takeya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Haruka Miyata
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Futa Ninomiya
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yutaka Nonoyama
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takuya Nakazawa
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yukiko Furuya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yasuyuki Enoki
- Department of Pathology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takashi Fujii
- Department of Radiotherapy, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Shigeharu Fukao
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| |
Collapse
|
8
|
Garofalo G, Bucella D, Thomas D, Buxant F. Fertility-sparing surgery for borderline ovarian Brenner tumor and subsequent childbirth: First case report and a literature review. Clin Case Rep 2022; 10:e6609. [PMID: 36483854 PMCID: PMC9723236 DOI: 10.1002/ccr3.6609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
Borderline ovarian Brenner tumors are rare malignancies mainly diagnosed after menopause. A first pregnancy after fertility-sparing surgery by laparoscopic unilateral salpingo-oophorectomy was reported in a previous article. We now report the first baby birth after unilateral salpingo-oophorectomy for a borderline ovarian Brenner tumor and a review of the literature.
Collapse
Affiliation(s)
- Giulia Garofalo
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium,Present address:
Erasme University Hospital, ULBBrusselsBelgium
| | - Dario Bucella
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium,Present address:
Saint Pierre University Hospital, ULBBrusselsBelgium
| | - Dominique Thomas
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium,Present address:
Erasme University Hospital, ULBBrusselsBelgium
| | - Frederic Buxant
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium
| |
Collapse
|
9
|
Fujita T, Takeya A, Miyata H, Ninomiya F, Nonoyama Y, Nakazawa T, Furuya Y, Enoki Y, Fujii T, Fukao S. Thoracic spinal metastasis as recurrence of borderline Brenner tumor without local recurrence: A case report. Gynecol Oncol Rep 2022; 44:101108. [PMID: 36506037 PMCID: PMC9731387 DOI: 10.1016/j.gore.2022.101108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Brenner tumor is a rare epithelial ovarian neoplasm that accounts for 2-3% of all ovarian neoplasms. Herein, we report the first case of thoracic spinal metastasis of recurrent Brenner tumor without local recurrence.Case Description.A 70-year-old female presented with a feeling of abdominal distension. Computed tomography revealed cystic lesions in her bilateral ovaries. Blood examination revealed high CA-125 [74.9 U/ml]. We excised bilateral ovaries, uterus, and omentum. Borderline Brenner tumor was diagnosed [Ki-67 labeling index: 10 %]. Follow-up abdominal echo and CA-125 examination revealed no local recurrence. 26 months later she developed paraplegia. Magnetic resonance imaging revealed tumor in the 5th-9th thoracic vertebra and compression of spinal cord at the 6th thoracic vertebra level. Her paraplegia was progressive. We performed semi-urgent partial resection of tumor and release of spinal cord compression. Spinal metastasis from Brenner tumor was diagnosed [Ki-67 labeling index: 50-60 %]. She received adjuvant radiation of 30 Gy in 10 fractions to the 4th-10th thoracic vertebra. After radiation and rehabilitation, she was discharged home on foot. She received adjuvant radiation and chemotherapy but died 11 months after spinal surgery. An autopsy has not been performed on her, and the cause of death is unknown. Conclusion We report the first case of thoracic metastasis of recurrent Brenner tumor without local recurrence.
Collapse
Affiliation(s)
- Tomoaki Fujita
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan,Corresponding author.
| | - Aya Takeya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Haruka Miyata
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Futa Ninomiya
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yutaka Nonoyama
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takuya Nakazawa
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yukiko Furuya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yasuyuki Enoki
- Department of Pathology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takashi Fujii
- Department of Radiotherapy, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Shigeharu Fukao
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| |
Collapse
|
10
|
Shetty S, Habeeb O, Rivera C, Astbury C, Przybycin C, Joehlin-Price AS. MDM2 amplification in malignant Brenner tumors may play a role in progression to malignancy and aid in separation from urothelial and other ovarian carcinomas. Hum Pathol 2021; 117:42-50. [PMID: 34391746 DOI: 10.1016/j.humpath.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/20/2022]
Abstract
Malignant Brenner tumor (MBT) is diagnosed in the setting of invasive high-grade carcinoma with urothelial-like morphology and the presence of an adjacent benign Brenner tumor (BBT) or borderline Brenner tumor (BLBT). MDM2 amplification was recently detected by next-generation sequencing on a small number of MBTs, potentially significant for future targeted therapy. Experience is limited, however, and evaluation of widely available MDM2 immunohistochemistry (IHC) has not been performed to determine clinical utility. After confirming all diagnoses morphologically and immunohistochemically, we performed MDM2 IHC on 4 MBTs, 3 BLBTs, 26 BBTs, 142 high-grade serous carcinomas (HGSC), 6 ovarian endometrioid carcinomas (OEC) with urothelial-like morphology, and 49 high-grade urothelial carcinomas (HGUC). MDM2 IHC was considered positive with diffuse (>25%) nuclear reactivity; in cases of patchy staining (10-25% nuclear reactivity), MDM2 was considered equivocal. Positive staining in <10% of cells was considered negative. In cases with positive or equivocal staining, MDM2 amplification was evaluated by fluorescence in-situ hybridization (FISH). Three MBTs (75%) showed diffuse nuclear reactivity for MDM2 by IHC, a finding corroborated by amplification of MDM2 in all three cases. One MBT and 2 BLBTs showed equivocal MDM2 IHC, but all three were negative for MDM2 amplification. The final BLBT, as well as all BBTs, HGSC, OEC, and HGUC, were negative for MDM2. In conclusion, our limited cohort confirms MDM2 amplification in MBT and suggests that MDM2 IHC may have an influence in rare diagnostically challenging cases.
Collapse
|
11
|
Siatecka H, Masand RP. Brenner tumor associated with rete ovarii: a histologic and immunohistochemical analysis of six cases exploring the relationship between these entities. Hum Pathol 2021; 113:84-91. [PMID: 33812844 DOI: 10.1016/j.humpath.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
The association of Brenner tumor (BT) with rete ovarii (RO) has been rarely alluded to in the literature. Both entities have debatable histogenesis. In this study of six cases of BT associated with RO, we describe the morphologic features and performed immunohistochemical staining for markers of Mullerian, Wolffian, mesothelial, and sex cord stromal derivation to explore the relationship between these entities. Histologically, all BTs were benign, microscopic, and incidental. RO was prominent and hyperplastic with gradual or abrupt transition to BT. In addition, focal areas of rete entrapped between BT nests were seen. All BTs were positive for GATA-3 and negative for PAX-8. Conversely, the RO in all cases was negative for GATA-3 and positive for PAX-8. WT-1 was positive in both entities. Sex cord stromal and mesothelial markers (other than WT-1) were negative in BT and RO. Although morphologically, BTs seem to arise from RO in these cases, they have a distinct immunophenotype. It is possible that at least some BTs arise from metaplastic changes in RO epithelium.
Collapse
Affiliation(s)
- Hanna Siatecka
- Baylor College of Medicine, Department of Pathology & Immunology, Houston, TX, 77030, USA
| | - Ramya P Masand
- Baylor College of Medicine, Department of Pathology & Immunology, Houston, TX, 77030, USA.
| |
Collapse
|
12
|
Salibay CJ, Zanfagnin V, Miller H, Walia S, Brunette LL, Wang T. Borderline Brenner Tumor of the Ovary Coexisting With an Ovarian Mucinous Cystadenoma With Focal Atypical Epithelial Proliferation: A Rare Case With Review of the Literature. Int J Surg Pathol 2021; 29:788-793. [PMID: 33635096 DOI: 10.1177/1066896921999459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Ovarian Brenner tumors, accounting for ∼5% of overall ovarian epithelial neoplasm, are often reported in association with mucinous neoplasm. Histogenetically, the two tumors are thought to arise from similar precursors. To date, fewer than 60 borderline Brenner tumors alone have been reported, and the concomitant presence of atypical proliferative components in Brenner and mucinous tumors is even rarer. Therefore, the clinicopathological characteristics and prognosis of patients with the borderline Brenner tumors alone or coexisting with mucinous neoplasm are extremely limited. Herein, we report a unique case of a 53-year-old woman with a unilateral ovarian borderline Brenner tumor associated with focal atypical mucinous epithelial proliferation and her clinical presentations. The clinicopathological features of the tumor are documented and the literature review along with the clinical molecular advances are summarized in this study.
Collapse
Affiliation(s)
- Christine J Salibay
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Valentina Zanfagnin
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Heather Miller
- Department of Clinical Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Saloni Walia
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laurie L Brunette
- Department of Clinical Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Tiannan Wang
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
13
|
Parcesepe P, Coppola L, Remo A, D’Andrea MR, Coppola G, Simbolo M, Manfrin E, Scarpa A, De Santis E, Giordano G. Molecular and Clinical Insights in Malignant Brenner Tumor of the Testis With Liver Metastases:A Case Report. Front Oncol 2021; 11:663489. [PMID: 33912469 PMCID: PMC8072450 DOI: 10.3389/fonc.2021.663489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/25/2021] [Indexed: 02/05/2023] Open
Abstract
Malignant Brenner Tumor (mBT) is extremely rare. Although BT are almost exclusive ovarian neoplasms, they may constitute a highly unusual tumor of the testis; in fact, only seven fully documented cases have been reported to date. Because of their rarity, the pathogenesis of these tumors has not been clarified and there is no standard therapeutic approach. We report the first case of epididymal mBT with synchronous, multiple, liver metastases and a very dramatic clinical course. Both primary tumor and metastasis were subjected to mutational analysis of 20 cancer associated genes. Primary tumor showed FGFR3 Tyr375Cys and PIK3CA His1047Arg missense mutations. Both mutations are reported as pathogenic in ClinVar database. The same FGFR3 mutation was present in liver metastasis. Based on these results we believe that the FGFR pathway could be an ideal candidate for personalized treatment, offering hope to a subset of patients with mBT. Personalized approach, including mutational analysis and molecular testing should be required in patients with rare tumors in order to clarify diagnosis and improve therapeutic strategies.
Collapse
Affiliation(s)
- Pietro Parcesepe
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- *Correspondence: Pietro Parcesepe, ; Guido Giordano,
| | - Luigi Coppola
- Unità Operativa Complessa (UOC) Anatomia ed Istologia Patologica e Citologia Diagnostica, Dipartimento dei Servizi Diagnostici e della Farmaceutica, Ospedale Sandro Pertini, Roma, Italy
| | - Andrea Remo
- Pathology Unit, “Mater Salutis” Hospital, Legnago, Italy
| | - Mario Rosario D’Andrea
- Unità Operativa Semplice a valenza Dipartimentale (UOSD) Oncologia, Ospedale S. Paolo, Civitavecchia, Italy
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Michele Simbolo
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | - Erminia Manfrin
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Polilinico Riuniti, Foggia, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Pietro Parcesepe, ; Guido Giordano,
| |
Collapse
|
14
|
Nazari F, Dehghani Z. Coexistence of Benign Brenner Tumor with Mucinous Cystadenoma in an Ovarian Mass. Iran J Pathol 2020; 15:334-337. [PMID: 32944047 PMCID: PMC7477685 DOI: 10.30699/ijp.2020.104017.2052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/22/2020] [Indexed: 11/06/2022]
Abstract
Ovarian cancer is the most lethal gynecologic malignancy. The surface epithelial tumor is the most common type of ovarian cancer. Among these, the mucinous tumors account for 10-15% of ovarian tumors. Mucinous ovarian tumors are among the most difficult ovarian neoplasms for surgical pathologists to interpret. Mucinous tumors sometimes coexist with other surface epithelial tumors. Therefore, making the accurate diagnosis of the mucinous tumors is essential. On the other hand, association of Brenner tumors with other neoplasms is rare. Ovarian Brenner tumor has always been discussed by pathologists as an enigmatic tumor, because of its rarity and disputed histogenesis. Here, we reported a case of large mucinous cystadenoma with Brenner component.
Collapse
Affiliation(s)
- Farzaneh Nazari
- Department of Gynecology and Obstetrics, School of medicine, Bushehr university of medical sciences, Bushehr, Iran
| | - Zahra Dehghani
- Department of Pathology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| |
Collapse
|
15
|
Gaur JH, Hassan MJ, Elahi AA, Khetrapal S, Khan S, Jetley S. Synchronous benign Brenner's tumor of ovary with leiomyoma and endometrial adenocarcinoma in a postmenopausal female. J Cancer Res Ther 2020; 15:1418-1420. [PMID: 31898686 DOI: 10.4103/jcrt.jcrt_109_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Brenner tumors of ovary are usually an incidental finding. It is an uncommon tumor which is seen affecting women of fifth to sixth decade. It is classified under transitional cell tumors of ovary, which includes benign, borderline, and malignant Brenner tumors and transitional cell carcinoma. These tumors have been associated with synchronous and metachronous neoplasia, most commonly other ovarian epithelial tumors such as mucinous cystadenoma. Occasionally, these tumors may be associated with endometrial hyperplasia or carcinomas which are due to hormones elaborated by the stromal component of Brenner tumor. The hormone produced is estrogen and less commonly androgens, which alters the estrogen and progesterone levels, causing hyperstimulation of endometrium. We present a case of 50-year-old postmenopausal women who presented with coexisting incidental Brenner tumor with leiomyoma and Endometrial adenocarcinoma. Only few authors have reported similar tumor occurrence in the past.
Collapse
Affiliation(s)
- Jyotsana Harit Gaur
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Mohammad Jaseem Hassan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Arifa Anwar Elahi
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Shaan Khetrapal
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sabina Khan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sujata Jetley
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| |
Collapse
|
16
|
Bagga R, Pandit R, Saha PK, Kalra J, Muthyala T, Gupta N, Singh T, Rai B. A Rare Case of Grade 1 Endometrioid Adenocarcinoma of the Uterus With Omental Metastasis with Brenner Tumor of the Ovary in a Postmenopausal Female. J Midlife Health 2020; 11:45-48. [PMID: 32684728 PMCID: PMC7362985 DOI: 10.4103/jmh.jmh_141_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 08/05/2019] [Accepted: 08/17/2019] [Indexed: 11/08/2022] Open
Abstract
Early-stage endometrial cancer may have microscopic omental metastases which is associated with a poor prognosis. There are no standard guidelines for omentectomy in early-stage endometrial cancer without risk factors. Brenner tumor is a rare ovarian tumor which is usually benign, but rarely, it may be malignant. Some Brenner tumors are endocrinologically active. Various studies have shown an association of Brenner tumor with endometrial hyperplasia, polyp, or early-stage carcinoma, probably due to its estrogen-secreting nature. We report a rare case of well-differentiated endometrioid adenocarcinoma of the uterus with <50% myometrial invasion with omental metastases associated with benign Brenner tumor of the ovary in a postmenopausal female.
Collapse
Affiliation(s)
- Rashmi Bagga
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rubina Pandit
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pradip Kumar Saha
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jasvinder Kalra
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tanuja Muthyala
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Nalini Gupta
- Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tulika Singh
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhavna Rai
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
17
|
Hu RY, Deng YJ, Zhu HH, Zhou J, Hu M, Liang XQ, Xiao QJ, Zhou L, Peng XY, Zhang XW, Ji N, Deng H. Extraovarian Brenner tumor in the uterus: a case report and review of literature. Diagn Pathol 2020; 15:22. [PMID: 32164751 PMCID: PMC7066756 DOI: 10.1186/s13000-019-0906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extraovarian Brenner tumors (EOBTs) are extremely rare and can be observed incidentally in both female and male patients, raising concerns regarding the origin of Brenner tumors. CASE PRESENTATION A 53-year-old postmenopausal woman presented with a nodular lesion in the left side of the corpus uteri, which was found at a routine health check. Macroscopically, the lesion appeared as a solid nodule with a yellowish-gray cut surface, approximately 6 cm in greatest diameter. Microscopically, the lesion consisted of well-defined epithelial nests and spindled stromal cells. Parenchymal cells expressed CK7, GATA3, CK5/6, 34βE12, and p63. A single layer of cavity-lined cells with umbrella-like shape showed apical Uroplakin III positivity. Stromal cells were positive for SMA, ER, and PR. The final diagnosis was EOBT and the patient was followed for 2 months with no recurrence. CONCLUSIONS We report here the third case of EOBTs in the uterus. The combination of morphologic and immunohistochemical results supported the involvement of urothelial metaplasia in the development of EOBTs. The similarities between EOBTs and Walthard nests made Müllerian epithelium an attractive candidate as the cellular origin. Changes of tissue structure or sex hormones imbalance may lead to the translocation of Müllerian remnants to distant organs, explaining the pathogenesis of EOBTs.
Collapse
Affiliation(s)
- Rui-Yue Hu
- Department of Pharmacology, Renmin Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Yan-Juan Deng
- Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, 133 South Guangchang Road, Nanchang, 330003, China
| | - Hao-Hao Zhu
- Department of Pathology, the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, 330003, China
| | - Jing Zhou
- Department of Gynecology and Obstetrics, the Fourth Affiliated Hospital of Nanchang University, Nanchang, 330003, Jiangxi Province, China
| | - Ming Hu
- Department of Gynecology and Obstetrics, the Fourth Affiliated Hospital of Nanchang University, Nanchang, 330003, Jiangxi Province, China
| | - Xiao-Qing Liang
- Department of Gynecology and Obstetrics, the Fourth Affiliated Hospital of Nanchang University, Nanchang, 330003, Jiangxi Province, China
| | - Qiu-Jin Xiao
- Department of Ultrasonography, the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Nanchang, 330003, China
| | - Lv Zhou
- Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, 133 South Guangchang Road, Nanchang, 330003, China
| | - Xiao-Yu Peng
- Department of Ultrasonography, the Fourth Affiliated Hospital of Nanchang University, Nanchang, 330003, Jiangxi Province, China
| | - Xing-Wei Zhang
- Medical College, Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Ning Ji
- Medical College, Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Huan Deng
- Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, 133 South Guangchang Road, Nanchang, 330003, China.
| |
Collapse
|
18
|
Lata Verma M, Tripathi V, Singh U, Agarwal P, Sachan R, Lata Sankwar P. Peritoneal tuberculosis with benign ovarian tumor. Indian J Tuberc 2019; 66:499-501. [PMID: 31813439 DOI: 10.1016/j.ijtb.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 12/24/2018] [Indexed: 12/06/2022]
Affiliation(s)
| | | | - Uma Singh
- Dept of Obstetrics and Gynaecology, KGMC, Lucknow, India.
| | | | - Rekha Sachan
- Dept of Obstetrics and Gynaecology, KGMC, Lucknow, India.
| | | |
Collapse
|
19
|
Weinberger V, Minář L, Felsinger M, Ovesná P, Bednaříková M, Číhalová M, Jandáková E, Hausnerová J, Chaloupková B, Zikán M. Brenner tumor of the ovary - ultrasound features and clinical management of a rare ovarian tumor mimicking ovarian cancer. Ginekol Pol 2018; 89:357-363. [PMID: 30091444 DOI: 10.5603/gp.a2018.0061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/25/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To describe the ultrasound features of benign Brenner tumor in the background of complex clinical and histopathological pictures. MATERIAL AND METHODS We retrospectively identified patients with histologically confirmed benign Brenner tumor of the ovary who were treated in our institution in 2003-2016, and for whom complete imaging, clinical, perioperative and histopathological data were available in the database. Ultrasound findings were drawn from images and reports using terms and definitions of the International Ovarian Tumor Analysis group and pattern recognition description was applied. RESULTS Twenty-three patients were identified, most postmenopausal and asymptomatic. On ultrasound, 19/23 tumors were found unilaterally, 4/23 bilaterally, and 82% of tumors were detected in the left ovary. Most Brenner tumors (16/23) contained solid components and revealed no or minimal blood flow by subjective color score upon Doppler examination (19/23, 83%). Calcifications with shadowing were observed in 57% of all Brenner tumors and in 81% of tumors containing solid components. The complex appearance of the tumor misled the sonographers to describe the mass as malignant in 9 cases (39%), and frozen section was performed perioperatively. Surgery was performed via laparoscopy in 11 (48%) and via laparotomy in 12 (52%) cases. CONCLUSIONS The complexity of the ultrasound picture, consisting of features like calcifications with acoustic shadowing, a poorly vascularized solid mass, and a left-sided localization could be signs of a benign Brenner tumor and could preop-eratively help to differentiate between benign and malignant tumor.
Collapse
Affiliation(s)
- Vit Weinberger
- University Hospital Brno, Department of Obstetrics and Gynecology, Medical Faculty, Masaryk University, Jihlavska 20, 62500 Brno, Czech Republic.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Zhao Y, Mao X, Yao L, Shen J. Computed tomography imaging features of benign ovarian Brenner tumors. Oncol Lett 2018; 16:1141-1146. [PMID: 30061939 DOI: 10.3892/ol.2018.8766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/13/2018] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to describe the computed tomography (CT) imaging features of ovarian Brenner tumor for diagnostic accuracy and disease understanding. The CT imaging features of 9 cases of ovarian Brenner tumor confirmed by surgery and pathology were retrospectively analyzed and compared. Of the 9 cases of ovarian Brenner tumor, 3 were right located and 6 were left located with clear borders; 7 with round or oval shapes, while 2 were with irregular and lobulated morphology; 5 solid lesions presented with multiple scattered calcification shadows inside with moderate enhancement, while 3 cystic lesions were presented with mixed solid and cystic composition, and significant enhancement was identified in the solid component, but not in the cystic component. Furthermore, papillary projections inside and mild nodular enhancement were observed in one case of cystic lesion. The pathological analysis demonstrated that an epithelium nest composed the tumors with urothelial like cells and fibrous matrix. Of the 9 cases, 5 epithelial nests exhibited adeno-like cystic lumen without cell mitosis phase. All cases were diagnosed with benign ovarian Brenner tumor. Specific CT imaging features of ovarian Brenner tumor can be identified and pathological examinations are required for diagnosis confirmation.
Collapse
Affiliation(s)
- Yuying Zhao
- Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313003, P.R. China
| | - Xinfeng Mao
- Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313003, P.R. China
| | - Lidi Yao
- Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313003, P.R. China
| | - Jian Shen
- Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313003, P.R. China
| |
Collapse
|
21
|
Dougherty D, Onyemkpa C, Engel M, Oyasiji T. A case report of an incidental Brenner tumor found after resection of a large ovarian mucinous neoplasm. Int J Surg Case Rep 2018; 49:40-43. [PMID: 29960208 PMCID: PMC6039703 DOI: 10.1016/j.ijscr.2018.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/01/2018] [Accepted: 05/11/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Brenner Tumors are rare adenofibromas that are most commonly benign and discovered in post-menopausal women. PRESENTATION OF CASE This is a case report of a 57-year-old female with three months of progressively worsening abdominal pain due to a large abdominal mass discovered on CT scan. Surgical removal of the mass revealed a giant mucinous tumor of the ovary with an associated Brenner tumor that was discovered incidentally. DISCUSSION Although the Brenner tumor was accurately identified in the intraoperative frozen section evaluation, the mucinous tumor was underdiagnosed by frozen section as benign when permanent section revealed borderline mucinous cystadenoma. This finding did not change the treatment course for this particular patient as she had expressed personal preference for total abdominal hysterectomy. However, underdiagnosis of frozen sections of ovarian tumors is not rare. It is unclear whether an associated Brenner tumor increases malignancy potential. CONCLUSION Further investigation is required to determine whether associated Brenner tumors found during frozen section are more highly associated with malignancy and could therefore change intraoperative and overall decision making.
Collapse
Affiliation(s)
- Danielle Dougherty
- Michigan State University, Department of Surgery, 1200 East Michigan Ave., Suite 655, Lansing, MI 48912, United States.
| | - Chibueze Onyemkpa
- Michigan State University, Department of Surgery, 1200 East Michigan Ave., Suite 655, Lansing, MI 48912, United States
| | - Michael Engel
- McLaren Medical Group, 2487 North Elms Road, Flushing, MI 48433, United States
| | - Tolutope Oyasiji
- Department of Surgical Oncology, Barbara Ann Karmanos Cancer Institute at McLaren Flint, Wayne State University, 4100 Beecher Road, Flint, MI 48532, United States, & Department of Surgery, Michigan State University
| |
Collapse
|
22
|
Tamás J, Vereczkey I, Tóth E, Csernák E, Purcsi K, Pete I. Mixed Ovarian Tumor Composed of Brenner Tumor and Adult-Type Granulosa Cell Tumor: A Case Report of a Very Rare Mixed Ovarian Tumor and a Review of the Literature. Int J Surg Pathol 2017; 26:382-387. [PMID: 29198156 DOI: 10.1177/1066896917744877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A combination of ovarian tumors with the same histogenetic origin but different histologic subtype is relatively common, whereas a co-occurrence of tumors with different histogenetic origin is rare. We report a case of mixed ovarian tumor composed of Brenner tumor and adult-type granulosa cell tumor, a combination that to the best of our knowledge has not been reported in the literature until now.
Collapse
Affiliation(s)
- Judit Tamás
- 1 National Institute of Oncology, Budapest, Hungary
| | | | - Erika Tóth
- 1 National Institute of Oncology, Budapest, Hungary
| | | | | | - Imre Pete
- 1 National Institute of Oncology, Budapest, Hungary
| |
Collapse
|
23
|
Turgay B, Koyuncu K, Taşkın S, Ortaç UF. Features of ovarian Brenner tumors: Experience of a single tertiary center. Turk J Obstet Gynecol 2017; 14:133-137. [PMID: 28913150 PMCID: PMC5558414 DOI: 10.4274/tjod.98216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/15/2017] [Indexed: 12/01/2022] Open
Abstract
Objective: Brenner tumors are rare neoplasms of the ovary. The aim of this study was to investigate the clinical features of Brenner tumors. Materials and Methods: The clinical features of 22 patients who were treated in Ankara University Faculty of Medicine Obstetrics and Gynecology Department between 2005 and 2015 were evaluated retrospectively from hospital medical records. Results: The patients were aged 34 to 79 years at the time of diagnosis and the mean age was 55.1 years. Two (9.1%) patients were pre-menopausal, five (22.7%) were peri-menopausal, and 25 (68.2%) patients were postmenopausal. One patient was pregnant. Twenty of the neoplasms were benign, one was malignant, and one was both malignant and benign. There was no recurrence in the malignant cases. Six (27.2%) patients had mixed tumors consisting of Brenner tumor and another ovarian pathology. Specifically, the other component of these tumors was mucinous cystadenoma in four patients, endometriosis externa in one patient, and high-grade serous papillary cyst adenocarcinoma in one patient. Conclusion: Brenner tumors are usually incidental benign pathologic findings of surgical procedures in postmenopausal women. They can be found with other ovarian pathologies such as mucinous ovarian tumors and can coexist with other female genital tumors. Further studies are needed to completely understand the clinical features of Brenner tumors.
Collapse
Affiliation(s)
- Batuhan Turgay
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Kazibe Koyuncu
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Salih Taşkın
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Uğur Fırat Ortaç
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| |
Collapse
|
24
|
Hwang CS, Lee CH, Lee SJ, Kim YG, Kim A, Park DY, Kang HJ, Shin DH. A peculiar case report of extraovarian Brenner tumor arising in the omentum. World J Surg Oncol 2017; 15:72. [PMID: 28351362 PMCID: PMC5370456 DOI: 10.1186/s12957-017-1135-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 03/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background Brenner tumors almost always develop in the ovary. Exceptionally, extraovarian Brenner tumors have been reported in the lower abdomen or pelvic organs. Here, we introduce a peculiar case of an extraovarian Brenner tumor arising in the omentum. Case presentation A 43-year-old woman presented with a palpable abdominal mass. Computed tomography (CT) scan revealed a 9.0-cm solid mass in the omentum. The tumor was not associated with pelvic structures, including the ovaries. It was excised under the clinical impression of an extragastrointestinal stromal tumor or neurogenic tumor. Grossly, the mass was a well-circumscribed solid tumor, with yellow-tan cut surface and minute cystic spaces. Microscopically, the tumor showed well-defined epithelial nests with variable cystic changes embedded in an abundant fibrous stroma. The cells within the nests were reminiscent of benign urothelial cells in that they had oval, frequently grooved nuclei. The epithelial cells focally showed a gradual transition into the surrounding stromal cells with short spindled features. The urothelium-like cells were positive for pancytokeratin, WT-1, p63, CK7, uroplakin-III, and GATA-3 but were negative for CD34, CD10, CK20, c-KIT, DOG-1, PAX-8, and calretinin. Morphological and immunohistochemical features of the tumor were the same as an ovarian Brenner tumor, and so it was diagnosed as an extraovarian Brenner tumor. Conclusions Although the location of the tumor was very unusual, we could diagnose the tumor as an extraovarian Brenner tumor on the basis of the histologic and immunohistochemical findings. This is the first case of extraovarian Brenner tumor arising in the omentum near the stomach ever reported in the English literature.
Collapse
Affiliation(s)
- Chung Su Hwang
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Chang Hun Lee
- Department of Pathology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
| | - So Jeong Lee
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Young Geum Kim
- Department of Pathology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ahrong Kim
- Department of Pathology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Do Youn Park
- Department of Pathology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyun Jeong Kang
- Department of Pathology, Munhwa Hospital, Busan, Republic of Korea
| | - Dong Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| |
Collapse
|
25
|
Minato J, Tokunaga H, Okamoto S, Shibuya Y, Niikura H, Yaegashi N. Is Imprint Cytology Useful to Diagnose Malignancy for Brenner Tumors? A Case Series at a Single Institute. Acta Cytol 2017; 61:153-159. [PMID: 28231585 DOI: 10.1159/000455997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to investigate cytological features of Brenner tumors according to tumor grade using imprint cytology. CASE Between 2004 and 2015, intraoperative imprint cytology was performed on 8 patients with Brenner tumors suspected to be malignant neoplasmas on gross examination because of their large size and solid part. These consisted of 1 benign, 3 borderline, and 4 malignant tumors. In patients with benign and borderline tumors, naked nucleus-like stromal cells and tumor cells in a sheet-like arrangement were observed against a clear background. The nuclei were round to oval-shaped with finely granular chromatin patterns and small nucleoli. Papillary cell clusters and high nucleus-to-cytoplasm ratios were only observed in 1 borderline case. In cases with malignancy, the background was necrotic. The tumor cells occurred in large papillary clusters. The nuclei showed a high degree of nuclear atypia. Nuclear grooves were present in 6 of our 8 cases and they were scant in the malignant cases. CONCLUSION Imprint cytology of Brenner tumors provided no characteristic findings to enable a definitive distinction of benign versus borderline tumors, but it enabled discrimination between malignant and other tumors. Imprint cytology can facilitate intraoperative diagnosis and aid in selecting the appropriate surgical procedure.
Collapse
Affiliation(s)
- Junko Minato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | | | | |
Collapse
|
26
|
Abstract
Brenner tumor is a rare ovarian neoplasm that is seen in women of the fifth to sixth decade. Classified as benign, borderline, and malignant, these tumors may be associated with estrogen production, thus altering the estrogen–progesterone ratio. High estrogen stimulates the endometrium and this is responsible for producing various pathologies, namely, hyperplasia, atypia, and carcinoma. Very few case reports have been published highlighting the same. A case report is being presented here of a coexisting Brenner tumor and well-differentiated endometrial carcinoma in a 55-year-old nulliparous postmenopausal woman.
Collapse
Affiliation(s)
- Mitakshara Sharma
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Babita Khangar
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Sangeeta Gupta
- Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
27
|
Quan J, Jin L, Hu J, He T, Pan X, Ding Y, Peng J, Chen Z, Yang S, Mao X, Lai Y. Brenner tumor of the testis: A case report and review of the literature. Mol Clin Oncol 2016; 6:119-121. [PMID: 28123743 DOI: 10.3892/mco.2016.1083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 05/30/2016] [Indexed: 01/09/2023] Open
Abstract
Brenner tumor is a rare type tumor, which mainly develops in the ovaries and rarely in the adnexal region and urinary system. To the best of our knowledge, only 5 cases of testicular Brenner tumor have been reported to date. In this report, we present the case of a 55-year-old patient who noted a swelling of the right scrotum for ~20 days. The clinical suspicion was an epididymal cyst. However, following surgical resection and subsequent pathological examination, the mass was diagnosed as a testicular Brenner tumor. A supplementary review of previously published cases and literature is also presented. The aim of this report is to help elucidate this disease and reduce the rate of clinical and pathological misdiagnosis.
Collapse
Affiliation(s)
- Jing Quan
- Department of Urology, The First Clinical College, Anhui Medical University, Hefei, Anhui 230032, P.R. China; Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Lu Jin
- Department of Urology, The First Clinical College, Anhui Medical University, Hefei, Anhui 230032, P.R. China; Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Jia Hu
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Department of Urology, Guangzhou Medical University, Guangzhou, Guangdong 510006, P.R. China
| | - Tao He
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China; Department of Urology, Guangzhou Medical University, Guangzhou, Guangdong 510006, P.R. China
| | - Xiang Pan
- Department of Urology, The First Clinical College, Anhui Medical University, Hefei, Anhui 230032, P.R. China; Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yu Ding
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Jian Peng
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Zhebo Chen
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Shangqi Yang
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Xiangming Mao
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yongqing Lai
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| |
Collapse
|
28
|
Abstract
Thyroid tissue is a relatively frequent component of mature teratoma and can occur in 5-20 % of cases. Struma ovarii is defined as ovarian goiter which comprises either entirely or predominantly thyroid tissue (>50 %). This also includes cases of mature teratoma with less than 50 % thyroid tissue but harboring thyroid-associated malignancy. A total of 118 patients with mature teratoma containing thyroid tissue were identified at our institution (1989 to 2014). Ninety-six cases were diagnosed struma ovarii, including 10 cases of papillary thyroid carcinoma, 1 case of highly differentiated follicular carcinoma of ovarian origin (HDFCO), 5 cases of strumal carcinoid, and 80 cases of struma ovarii (53 cases of thyroid-only struma ovarii). Six cases had diffuse adenomatous hyperplasia, and seven cases had focal adenomatous hyperplasia. There was no recurrence on follow-up except one of the papillary thyroid carcinomas. Concurrent primary ovarian lesions included: serous cystadenoma--3, mucinous cystadenoma--4, Brenner tumor--3, thecoma--2, ovarian fibroma--1, and focal hilus cell hyperplasia--4 cases. In this series, papillary thyroid carcinoma and strumal carcinoid were the most common well-differentiated neoplasm/malignancies arising in struma ovarii; these demonstrate a minimal or no aggressive clinical behavior.
Collapse
Affiliation(s)
- Shuanzeng Wei
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Zubair W Baloch
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| | - Virginia A LiVolsi
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
| |
Collapse
|
29
|
Abstract
The association of ovarian Brenner tumors and adjacent mucinous tumors is well known but not completely understood. In this study, we analyzed immunohistochemical markers on Brenner tumors and their associated mucinous tumor to explore Mullerian as well as Wolffian and germ cell derivation and determine if the mucinous component is independent or related to the Brenner tumor. Of 32 consecutive cases of Brenner tumors, 8 were identified with significant mucinous component, and 7 additional cases included foci of mucinous epithelium within the Brenner transitional nests. All Brenner tumors were diffusely positive for GATA3 and negative for Paired box gene 8, PAX2, and Sal-like protein 4. Interestingly, the areas of mucinous epithelium as well as mucinous tumors, intermixed and adjacent to the Brenner tumor, were negative for all 4 markers; however, occasional basal-like cells retained expression of GATA3. The immunoprofile of mucinous tumors associated with Brenner tumors shares the lack of Mullerian markers PAX2 and Paired box gene 8 with the Brenner tumor but differs in the expression of GATA3 only in the Brenner tumor component.
Collapse
Affiliation(s)
- Andres A Roma
- Department of Anatomic Pathology, Robert J Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.
| | - Ramya P Masand
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| |
Collapse
|
30
|
Ingin RJ, Andola SK, Zubair AA. Transitional cell carcinoma of the ovary: case series and review of literature. J Clin Diagn Res 2014; 8:FD07-8. [PMID: 25302204 DOI: 10.7860/jcdr/2014/9104.4733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/01/2014] [Indexed: 11/24/2022]
Abstract
Transitional cell carcinoma (TCC) of the ovary is a recently recognized, subtype of ovarian surface epithelial cancer; the pure form accounting for only 1% of surface epithelial tumors. It has been described as a primary ovarian carcinoma with definite urothelial features but no benign, metaplastic and/or proliferating Brenner tumor (BT) identified. Recognition of such tumours is important because of its rarity, favorable response to chemotherapy and an improved patient survival. A case series of primary TCC of the ovary (3 cases) with brief review of literature is being presented.
Collapse
Affiliation(s)
- Rajashree J Ingin
- Professor, Department of Pathology, M. R. Medical College , Gulbarga, India
| | - Sainath K Andola
- Professor & HOD, Department of Pathology, M. R. Medical College , Gulbarga, India
| | - Ashraf Ahmed Zubair
- Post-Graduate, Department of Pathology, M. R. Medical College , Gulbarga, India
| |
Collapse
|
31
|
Terada T, Tateoka K. Ovarian cystic tumor composed of Brenner tumor and struma ovarii. Int J Clin Exp Pathol 2012; 5:274-277. [PMID: 22558485 PMCID: PMC3341679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 03/11/2012] [Indexed: 05/31/2023]
Abstract
Ovarian tumor composed only of Brenner tumor and struma ovarii is very rare; only 6 cases have been reported in the English literature, to the best of the author's knowledge. A 66-year-old woman underwent right oophorectomy because of torsion of right ovarian cyst. Macroscopically, the ovarian cyst was hemorrhagic and red. Cystic content was hemorrhagic fluid. Microscopically, the cyst walls were composed only of Brenner tumor (50% in area) and struma ovarii (50% in area). Hemorrhage and ischemic changes were seen. Other elements were not recognized. No malignant transformation was noted. These two elements were separately present, and no mergers between them were recognized. Immunohistochemically, the Brenner tumor element was positive for cytokeratins (AE1/3 and CAM5.2) and Ki67 (labeling=3%), but negative for thyroglobulin, TTF-1, p53, CA125, and vimentin. The struma ovarii element was positive for cytokeratins (AE1/3 and CAM5.2), thyroglobulin, TTF-1 and Ki67 (labeling=5%), but negative for p53, CA125 and vimentin. The findings suggests that there were cases of ovarian cyst composed only of Brenner tumor and struma ovarii, that such a case may be monodermal mature cystic teratoma or the Brenner tumor element was derived from surface epithelium in the preexisting struma ovarii, and that such a tumor manifest as cystic torsion.
Collapse
Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
| | | |
Collapse
|
32
|
Abstract
Brenner tumor is a rare ovarian tumor that is a part of the surface epithelial group of ovarian neoplasm. It is usually asymptomatic and most of the times it is an incidental pathological finding. Here we present a case of benign Brenner tumor of ovary treated surgically.
Collapse
Affiliation(s)
- Tulon Borah
- Departments of Obstetrics and Gynecology, Vivekananda Kendra NRL Hospital, Numaligarh Refinery, Golaghat, Assam, India
| | | | | | | |
Collapse
|
33
|
Ziadi S, Trimeche M, Hammedi F, Hidar S, Sriha B, Mestiri S, Korbi S. Bilateral proliferating Brenner tumor of the ovary associated with recurrent urothelial carcinoma of the urinary bladder. N Am J Med Sci 2010; 2:39-41. [PMID: 22624111 PMCID: PMC3354386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT Brenner tumors of ovary are relatively uncommon neoplasm. Most of them are benign and less than 5% are proliferating or borderline. The association between Brenner tumor of the ovary and papillary urothelial carcinoma of bladder is extremely rare. CASE REPORT We describe an unusual case of proliferating bilateral Brenner tumor of the ovary with a highly recurrent low-grade papillary urothelial carcinoma of bladder. CONCLUSION The immunohistopathological similarities of ovarian and bladder tumors and their association in the current case, may be coincidental but may reflect a common initiating event inducing similar pathogenesis changes in the epithelium of both organs. More cases are needed to be reported to better understand this association.
Collapse
Affiliation(s)
- Sonia Ziadi
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia
| | - Mounir Trimeche
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia
| | - Faten Hammedi
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia,Correspondence to: Dr Faten Hammedi, Department of Pathology, Farhat Hached Hospital, 4000 Sousse, Tunisia. Tel.: +216 22 88 65 78, Fax: +216 73 210 355.
| | - Samir Hidar
- Department of Gynecology and Obstetrics, Farhat Hached Hospital, Sousse, Tunisia
| | - Baddredine Sriha
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia
| | - Sarra Mestiri
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia
| | - Sadok Korbi
- Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia
| |
Collapse
|