Case 81 - Discussion

Uploaded: 2007-08-14, Updated: 2007-08-27

   
  Benign Brenner tumor of the right ovary
CLINICAL FEATURES
 
  • An ovarian transitional cell tumor composed of mature urothelial-like cells arranged in solid or cystic aggregates within a predominantly fibromatous stroma;
  • 4-5% of benign ovarian epithelial tumor, 30-60 year-old;
  • Mostly asymptomatic, <2cm, discovered incidentally;
  • Occasionally secretion of estrogen or androgen by the stromal component.
GROSS FINDINGS
 
  • Small, often <2cm, well circumscribed with a firm, white and gritty sectioned surface due to calcification;
  • Often small cysts;
  • 25% cases associated with mucinous cystadenoma.
MICROSCOPIC FINDINGS
 
  • Transitional epithelial cells in nests and islands, solid or central lumen with dense eosinophilic mucin+ material;
  • The lumen may be lined by transitional cells, mucinous, ciliated or nondescript columnar cells;
  • The epithelial cells have centrally located, grooved, "coffee bean" nuclei, and abundant amphophilic to clear cytoplasm with distinct cellular borders;
  • Prominent fibromatous stroma.
DIFFERENTIAL DIAGNOSES
 
  • Borderline Brenner tumor: atypical or malignant epithelium, but no obvious invasion;
  • Malignant Brenner tumor: invasive TCC or SCC and benign or borderline tumor in a fibromatous stroma.
IMMUNOHISTOCHEMISTRY AND SPECIAL STAINS
 
  • Epithelial cells uroplakin positive
ELECTRON MICROSCOPIC FINDINGS
   
CYTOGENETIC STUDIES
   
TREATMENT AND PROGNOSIS
   
REFERENCES
 
  • WHO Classification, Tumor of the Breast and Female Genital Organs, IARC, 2003