Brenner tumors

Brenner tumors are rare ovarian neoplasms composed of ovarian transition cells surrounded by dense fibrous tissue. Most of them are small tumors (<2 cm), detected incidentally in asymptomatic women. Its predominantly fibrous content results in relatively low signal on T2 weighted images, establishing differential diagnosis with ovarian fibroma and thecoma. Their imaging features are very similar, the differentiation is based on secondary characteristics, such as signs or symptoms of estrogen excess and the presence of a second ovarian neoplasm, which has been reported in up to 30% of patients with Brenner tumor. Although originally thought to be universally benign, there have been scattered reports in the past decades of borderline and malignant forms of Brenner tumors.

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

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.

A Rare Case of Bilateral Malignant Brenner Tumors of the Ovaries Associated with Peritoneal Effusion

Background: Malignant ovarian Brenner tumors are extremely rare worldwide, accounting for only 1% of malignant ovarian tumors. Their clinical symptoms and pathology are complex and erratic, and the images are mostly non-specific. This poses difficulties in preoperative diagnosis and distinguishing them from other cystic solid ovarian tumors. Here this study has reported on a case of bilateral malignant ovarian Brenner tumor with peritoneal effusion. Case presentation: A 54-year-old woman presented with intermittent vaginal bleeding for more than two months and abdominal pain for one month. Two hard mass of five centimeters with poor movement could be touched at each side of the ovarian areas. The CT findings indicated the presence of two large cystic and solid masses in both adnexal regions. The operation had watched the size of the masses in the bilateral ovarian was both 6cmx6cmx5cm and their surface ulceration showed rotten fleshy tissue. After the operation, combined with morphological and immunohistochemical features, the ovarian specimens were consistent with bilateral ovarian malignant Brenner tumors.Conclusions: Although the incidence of bilateral malignant OBT is extremely low and this disease is extremely rare clinically, the gynecologists should be more informed of its diagnosis and treatment.

Amplification of MDM2 and Loss of p16 Expression: Do They Have a Role in Malignant Transformation of Ovarian Brenner Tumor?

Objectives To review the significance of MDM2 and cyclin D1 expression and loss of p16 expression in malignant and borderline Brenner tumors (BTs) of the ovary. Methods We describe 2 new cases of ovarian BT, 1 malignant and 1 borderline. We studied MDM2, p16, and cyclin D1 expression by immunohistochemistry in the benign, borderline, and malignant components of these 2 cases and in 5 additional cases of benign BT. We also reviewed and summarized the literature on the clinical, immunohistochemical and molecular characteristics of borderline and malignant BTs (BdBTs and MBTs). Results Nuclear expression of MDM2 was seen only in the MBT. Loss of p16 expression was seen in both BdBT and MBT. Cyclin D1 expression was in proportion to the degree of malignancy. Amplification of MDM2, loss of CDKN2A (p16-encoding gene), and amplification of CCND1 (cyclin D1–encoding gene) were confirmed by commercial next-generation sequencing in the case of MBT. Conclusions We are the first to report immunohistochemical expression of MDM2 in an MBT. Amplification of MDM2 and loss of p16 expression may have a role in malignant transformation of BT.

Solitary Fibrous Tumor of the Female Pelvis – Clues to the Radiological Diagnosis

Solitary fibrous tumors were initially described in the pleural cavity and they were thought to have mesothelial origin. Nowadays, these tumors are known to have origin in the mesenchymal cells and they are ubiquitous with both pleural and extrapleural distribution. There are many extrapleural localizations, being the pelvis one of the rarest and the most challenging to diagnose. Usually, solitary fibrous tumors are clinically insidious and manifest as a slow-growing large tumor. At imaging, these tumors have different characteristics, and computed tomography and magnetic resonance play an important role in their diagnosis. Solitary fibrous tumors appear as heterogeneous enhancement on contrast-enhanced computed tomography, intermediate signal on T1-weighted images, hypointense on T2-weightes images and show intense heterogeneous enhancement in dynamic sequences. When they appear in the female pelvis, it is essential to recognize their radiological characteristics, in order to differentiate it from others tumors, like pure stromal ovarian tumors or Brenner tumors. This study reviews the female pelvis solitary fibrous tumors’ imaging findings and its differential characteristics from more common tumors, by describing illustrative confirmed cases.

Bilateral Brenner tumor of ovary with associated unilateral mucinous cystadenoma: a case report

Brenner tumors are rare ovarian tumors, which are a subgroup of transitional cell tumors of ovary. Most of these tumors are benign presenting as incidental unilateral masses in postmenopausal age group. Only 5-7% cases are bilateral. These tumors are mostly small, solid and asymptomatic, seen commonly in association with mucinous cystadenomas of ovary. In such cases they may attain a massive size. Specific diagnosis of Brenner tumor is difficult using imaging studies and can be definitely diagnosed only on pathological examination. Surgical removal is usually curative for benign tumors. We present a rare case of bilateral Brenner tumor of ovary with associated unilateral mucinous cystadenoma in which bilateral Brenner tumor was a rare incidental finding on pathological examinatio