Морфологія (Sep 2016)
Malignant Brenner tumor: a case report.
Abstract
Background. Brenner tumors are ovarian transitional cell tumors histologically resembling transitional epithelium. Transitional cell tumors include benign, borderline, malignant Brenner tumor and transitional cell carcinoma. According to the World Health Organization transitional cell tumors constitute between 1 and 2 percent of all ovarian tumors. Malignant Brenner tumor accounts for 5% of all Brenner tumors. The histogenetic origin of Brenner tumors is not clear, but it is believed that they derive from paraovarian Walthard`s cell nests. Macroscopically Brenner tumors are of various sizes, white or yellow on the section. Histologically they are composed of cystic or solid cell nests of urothelial appearance with prominent stromal component surrounding them. Malignant Brenner tumor is characterized by cellular atypia and stromal invasion. Unlike transitional cell carcinoma, malignant Brenner tumor comprises components of benign and borderline counterparts. Case presentation. Patient B., 46 years old, was admitted to hospital with lower abdominal pain. After examination, the clinical diagnosis was: cyst of the right ovary. Surgical treatment included uterine extirpation with appendages and omental resection. Histopathological examination of the gross specimens concluded that there was: uterine leiomyoma, metastases of carcinoma and serous cyst in the left ovary, malignant carcinoma in the right ovary and metastatic infiltration of the omentum. Immunohistochemical investigation (CK7, CK20, CDX2, vimentin) confirmed the diagnosis of malignant Brenner tumor. Discussion. Generally, Brenner tumors are asymptomatic, but some cases accompanied with hyperestrogenism. In the presented case Brenner tumor accompanied with leiomyoma and serous ovarian cyst, but the most frequent combination – synchronous endometrial and ovarian carcinomas. The strong association that was observed in the presented case has been found between Brenner tumors and mucinous carcinomas. Conclusion. Brenner tumors are rare entities with vague histogenesis. We presented the clinical case of malignant Brenner tumor requiring differential diagnosis with metastatic tumors of gastrointestinal tract.
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