Brenner tumour explained

Brenner tumor
Field:Gynaecology, oncology

Brenner tumours are an uncommon subtype of the surface epithelial-stromal tumour group of ovarian neoplasms. The majority are benign, but some can be malignant.[1]

They are most frequently found incidentally on pelvic examination or at laparotomy.[2] Brenner tumours very rarely can occur in other locations, including the testes.[3]

Presentation

On gross pathological examination, they are solid, sharply circumscribed and pale yellow-tan in colour. 90% are unilateral (arising in one ovary, the other is unaffected). The tumours can vary in size from less than 1cm (00inches) to 30cm (10inches). Borderline and malignant Brenner tumours are possible but each are rare.

Diagnosis

Histologically, there are nests of transitional epithelial (urothelial) cells with longitudinal nuclear grooves (coffee bean nuclei) lying in abundant fibrous stroma.

The coffee bean nuclei are the nuclear grooves exceptionally pathognomonic to the sex cord stromal tumour, the ovarian granulosa cell tumour, with the fluid-filled spaces Call–Exner bodies between the granulosa cells.[4] [5]

Similar conditions

Transitional cell carcinoma is an even rarer entity, in which neoplastic transitional epithelial cells similar to transitional cell carcinoma of the bladder are seen in the ovary, without the characteristic stromal/epithelial pattern of a Brenner tumour.

Histologically, Leydig cell tumours of the testes and ovarian stromal Leydig cell tumours (ovarian hyperandrogenism and virilization) both have characteristic Reinke crystals. The same crystals were also noted under high-power view in Brenner tumours.[6]

Eponym

It is named for Fritz Brenner (1877 - 1969), a German surgeon who characterized it in 1907.[7] The term "Brenner tumour" was first used by Robert Meyer, in 1932.[8]

External links

Notes and References

  1. Marwah N, Mathur SK, Marwah S, Singh S, Karwasra RK, Arora B . Malignant Brenner tumour--a case report . Indian Journal of Pathology & Microbiology . 48 . 2 . 251–252 . April 2005 . 16758686 .
  2. Green GE, Mortele KJ, Glickman JN, Benson CB . Brenner tumors of the ovary: sonographic and computed tomographic imaging features . Journal of Ultrasound in Medicine . 25 . 10 . 1245–51; quiz 1252–4 . October 2006 . 16998096 . 10.7863/jum.2006.25.10.1245 .
  3. Caccamo D, Socias M, Truchet C . Malignant Brenner tumor of the testis and epididymis . Archives of Pathology & Laboratory Medicine . 115 . 5 . 524–527 . May 1991 . 2021324 .
  4. Web site: University of Virginia Medical School . Pathology Thread. https://web.archive.org/web/20060204142045/https://www.med-ed.virginia.edu/courses/path/gyn/ovary3.cfm . 4 February 2006 .
  5. Ahr A, Arnold G, Göhring UJ, Costa S, Scharl A, Gauwerky JF . Cytology of ascitic fluid in a patient with metastasizing malignant Brenner tumor of the ovary. A case report . Acta Cytologica . 41 . 4 Suppl . 1299–1304 . July 1997 . 9990262 . 10.1159/000333524 .
  6. Kuno Y, Baba T, Kuroda T, Teramoto M, Hirokawa N, Endo T, Saito T . Rare case of occult testosterone-producing ovarian tumor that was diagnosed by selective venous hormone sampling . Reproductive Medicine and Biology . 17 . 4 . 504–508 . October 2018 . 30377407 . 6194242 . 10.1002/rmb2.12213 .
  7. Lamping JD, Blythe JG . Bilateral Brenner tumors: a case report and review of the literature . Human Pathology . 8 . 5 . 583–585 . September 1977 . 903146 . 10.1016/S0046-8177(77)80117-2 .
  8. Book: Philipp EE, O'Dowd MJ . The history of obstetrics and gynaecology . Parthenon . Carnforth, Lancs . 2000 . 978-1-85070-040-1 . 586.