WBR0168: Difference between revisions
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|Explanation=The patient is most likely diagnosed with a [[Brenner tumor]], an ovarian non-germ cell tumor characterized by the presence of a solid, well-circumscribed, encapsulated pale yellow-tan tumor that shows epithelial ovoid nest cells with longitudinal grooving (coffee beans) on pathology. Brenner tumor is not a common diagnosis. It usually presents as an incidental finding during physical exam, ultrasound, or laparotomy. Other patients might complain of persistent abdominal discomfort of several months duration. Postmenopausal women are more likely to have Brenner tumors. Most tumors are benign and unilateral, with less than 10% being malignant. | |Explanation=The patient is most likely diagnosed with a [[Brenner tumor]], an ovarian non-germ cell tumor characterized by the presence of a solid, well-circumscribed, encapsulated pale yellow-tan tumor that shows epithelial ovoid nest cells with longitudinal grooving (coffee beans) on pathology. Brenner tumor is not a common diagnosis. It usually presents as an incidental finding during physical exam, ultrasound, or laparotomy. Other patients might complain of persistent abdominal discomfort of several months duration. Postmenopausal women are more likely to have Brenner tumors. Most tumors are benign and unilateral, with less than 10% being malignant. | ||
|AnswerA=Granulosa cell tumor | |AnswerA=Granulosa cell tumor | ||
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|References=Borah T, Mahanta RK, Bora BD, et al. Brenner tumor of ovary: An incidental finding. J Midlife Health. 2011;2(1):40-41. | |References=Borah T, Mahanta RK, Bora BD, et al. Brenner tumor of ovary: An incidental finding. J Midlife Health. 2011;2(1):40-41. | ||
|RightAnswer=B | |RightAnswer=B | ||
|WBRKeyword=brenner, tumor, tumors, ovarian, germ | |WBRKeyword=brenner, tumor, tumors, ovarian, germ, coffee, bean, appearance, gynecologic, abdominal mass, germ, cystadenoma, cystadenocarcinoma, krukenberg, yolk | ||
|Approved=Yes | |Approved=Yes | ||
}} | }} | ||
Revision as of 15:17, 29 August 2014
| Author | [[PageAuthor::Serge Korjian M.D. (Reviewed by Alison Leibowitz) (Reviewed by Serge Korjian)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Genitourinary, SubCategory::Oncology |
| Prompt | [[Prompt::A 52-year-old woman presents to her gynecologist for her annual check-up. On pelvic examination, the physician palpates a mobile mass in the left adnexa. Her physical examination is otherwise unremarkable. Ultrasound reveals a well-defined, 7x5 cm, lobulated left-sided ovarian tumor. Laparotomy is performed and the tumor is resected. On gross inspection, the tumor is observed to be a well-circumscribed, encapsulated, yellow-tan solid mass. Pathologic examination reveals epithelial ovoid nest cells with longitudinal grooves, resembling coffee beans(shown below). Which of the following is the most likely diagnosis?
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| Answer A | AnswerA::Granulosa cell tumor |
| Answer A Explanation | [[AnswerAExp::A granulosa cell tumor is an estrogen-secreting tumor that contains Call-Exner bodies, follicles filled with eosinophilic secretions.]] |
| Answer B | AnswerB::Brenner tumor |
| Answer B Explanation | [[AnswerBExp::A Brenner tumor is a unilateral, benign ovarian tumor that manifests as epithelial ovoid nest cells with longitudinal grooving on pathology (coffee bean appearance).]] |
| Answer C | AnswerC::Krukenberg tumor |
| Answer C Explanation | [[AnswerCExp::A Krukenberg tumor is characterized by the presence of mucin-secreting signet cells.]] |
| Answer D | AnswerD::Serous cystadenoma |
| Answer D Explanation | [[AnswerDExp::A serous cystadenoma is most likely a bilateral ovarian tumor lined with fallopian tube-like epithelium.]] |
| Answer E | AnswerE::Yolk sac tumor |
| Answer E Explanation | [[AnswerEExp::Frequently malignant, a yolk sac tumor is an ovarian germ cell tumor, often containing Schiller-Duval bodies resembling kidney glomeruli.]] |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::The patient is most likely diagnosed with a Brenner tumor, an ovarian non-germ cell tumor characterized by the presence of a solid, well-circumscribed, encapsulated pale yellow-tan tumor that shows epithelial ovoid nest cells with longitudinal grooving (coffee beans) on pathology. Brenner tumor is not a common diagnosis. It usually presents as an incidental finding during physical exam, ultrasound, or laparotomy. Other patients might complain of persistent abdominal discomfort of several months duration. Postmenopausal women are more likely to have Brenner tumors. Most tumors are benign and unilateral, with less than 10% being malignant. Educational Objective: A Brenner tumor is a well-circumscribed benign unilateral ovarian tumor that appears as epithelial ovoid nest cells with longitudinal grooving (coffee bean appearance) on pathology. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::brenner, WBRKeyword::tumor, WBRKeyword::tumors, WBRKeyword::ovarian, WBRKeyword::germ, WBRKeyword::coffee, WBRKeyword::bean, WBRKeyword::appearance, WBRKeyword::gynecologic, WBRKeyword::abdominal mass, WBRKeyword::germ, WBRKeyword::cystadenoma, WBRKeyword::cystadenocarcinoma, WBRKeyword::krukenberg, WBRKeyword::yolk |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |
