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==Overview== | ==Overview== | ||
Brenner tumors are an uncommon subtype of the [[surface epithelial-stromal tumor]] group of [[Ovarian cancer|ovarian neoplasm]]s. The majority are [[benign]], but some can be [[malignant]]. | Brenner tumors are an uncommon benign subtype of the [[surface epithelial-stromal tumor]] group of [[Ovarian cancer|ovarian neoplasm]]s. The majority are [[benign]], but some can be [[malignant]]. | ||
They are most frequently found incidentally on [[pelvic examination]] or at [[laparotomy]]. Brenner tumours very rarely can occur in other locations, including the [[testes]].<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref> | They are most frequently found incidentally on [[pelvic examination]] or at [[laparotomy]]. Brenner tumours very rarely can occur in other locations, including the [[testes]].<ref name=wikipedia>Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]
Synonyms and keywords: Brenner tumor of ovary; Brenner tumor of the ovary; Transitional cell tumour of the ovary; Ovarian transitional cell tumour
Overview
Brenner tumors are an uncommon benign subtype of the surface epithelial-stromal tumor group of ovarian neoplasms. The majority are benign, but some can be malignant. They are most frequently found incidentally on pelvic examination or at laparotomy. Brenner tumours very rarely can occur in other locations, including the testes.[1]
Historical Perspective
Brenner tumor was first described in 1907 by Fritz Brenner. The term "Brenner tumor" was first used by Robert Meyer, in 1932.[1]
Classification
Pathophysiology
Pathogenesis
90% of Brenner tumors are unilateral (arising in one ovary, the other is unaffected). The tumors can vary in size from less than 1cm to 30cm. Borderline and malignant Brenner tumours are possible but each are rare.[1]
May arise from the fallopian tube. Can be seen in the testis. Thought to arise from Walthard cell rest.
Genetics
Gross pathology
On gross pathology, a solid, well-circumscribed, and light yellow mass is the characteristic finding of Brenner tumor.[2]
- Solid, well-circumscribed, light yellow mass
- May be cystic
Gallery
-
![Brenner tumor[1]](/images/4/49/Brenner_tumor1.jpg)
Brenner tumor[1]
![Brenner tumor[1]](/index.php/File:Brenner_tumor1.jpg)
Microscopic Pathology
On microscopic histopathological analysis, nests of transitional epithelium cells, coffee bean nucleus, and dense fibrous stroma around nests are characteristic findings of Brenner tumor.[2]
- Nests of transitional epithelium cells[2]
- A "coffee bean nucleus"
- Elliptical shape
- Nuclear grooves
- Distinct nucleoli
- Moderate-to-abundant gray or pale cytoplasm
- Dense fibrous stroma around nests
Gallery
-
![Brenner tumor[2]](/images/3/38/Brenner_tumor2.jpg)
Brenner tumor[2]
![Brenner tumor[2]](/index.php/File:Brenner_tumor2.jpg)
Causes
Differentiating Brenner tumor from other Diseases
Brenner tumor must be differentiated from ovarian fibroma and thecoma.
- Ovarian fibroma
- Ovarian fibrothecoma
- Pedunculated leiomyoma
Epidemiology and Demographics
Prevalence
Brenner tumours account for up to 3.2% of ovarian epithelial neoplasms.
Incidence
Age
Most often found incidentally in women between their 5th and 7th decades of life.
Gender
Risk Factors
Screening
Natural history, Complications, and Prognosis
Natural history
- Mostly benign clinical course.
- May be malignant - rarely (~1% of Brenner tumours).
- Approximately 6-7% of Brenner tumours can be bilateral.
- They can very rarely can occur in other locations, including the testis.
- Tumours are usually small (< 2cm). Even with the occasional large tumour (> 10 cm), there is often a lack of local invasion, lymphadenopathy, ascites, or metastases (i.e. peritoneal metastases and omental caking) which help distinguish it from other malignant ovarian neoplasms.
Complications
Prognosis
Diagnosis
Staging
History and Symptoms
They are most frequently found incidentally on pelvic examination or at laparotomy.
Physical Examination
Laboratory Findings
X Ray
CT
calcifications have been reported in ~ 83% of Brenner tumours on CT. solid component may show mild to moderate enhancement post contrast.
MRI
MRI may be helpful in the diagnosis of Brenner tumor. Findings on MRI suggestive of Brenner tumor is hypointense on T2 weighted sequences.
Ultrasound
Ultrasound may be helpful in the diagnosis of Brenner tumor. Findings on ultrasound suggestive of Brenner tumor is a hypochoic solid mass that may be accompanied by calciication.
- Findings on ultrasound suggestive of Brenner tumor include:
- Hypochoic solid masses
- Calciication (Calcifications have been reported in 50% of Brenner tumours on ultrasound)
Other Imaging Findings
Other Diagnostic Studies
Biopsy
References
- ↑ 1.0 1.1 1.2 1.3 Brenner tumor. Wikipedia 2015. https://en.wikipedia.org/wiki/Brenner_tumour
- ↑ 2.0 2.1 2.2 2.3 Brenner tumor. Librepathology 2015. http://librepathology.org/wiki/index.php/Brenner_tumour