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[Brenner tumor].

13 Brenner tumors were studied clinicomorphologically. The tumor nests are once again shown to arise in the benign variant due to the proliferation of the mucose-forming epithelium in the cysts with one-layer lining. Morphogenesis of the papillary structures in the border-line variety of the tumor is demonstrated. Three observations of the malignant Brenner tumors are described in which the relation to the preexisting nests of the benign analogue is proved. The hypothesis is proposed on the analogy of the morphogenetic mechanisms of the Brenner tumor structures formation with the processes of the proliferation of cervical channel cambial cells with their successive epidermization. It is suggested that the combination of mucinous cysts with Brenner tumor nests is one and the same process.

Aged↗

Proliferating Brenner tumor.

Proliferating Brenner tumor is rare as there are only 17 previously reported cases. A case of proliferating Brenner tumor is presented with special emphasis on the pathologic and histologic findings. This variant of Brenner tumor is considered to be benign, as no recurrences have developed in any reported patients.

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Left ovarian Brenner tumor.

Ovarian Brenner tumors are uncommon neoplasms of the ovary, representing approximately 2% of all ovarian neoplasms. Nowadays there is general agreement that Brenner tumors are derived from the surface epithelium of the ovary or the pelvic mesothelium through transitional cell metaplasia. Association with other surface-derived neoplasms, either in the ipsilateral or contralateral ovary, is reported in 30% of the cases. We report a case of benign ovarian Brenner tumor and discuss the typical features on magnetic resonance imaging (MRI) and computed tomography (CT) scan as well as the differential diagnosis.

Aged↗

Extraovarian Brenner tumor.

Extraovarian Brenner tumors are exceedingly rare. Only four cases of extragonadal tumors have been reported in women, and three cases in men. We describe an extraovarian Brenner tumor discovered incidentally in the broad ligament at vaginal hysterectomy.

Brenner Tumor↗

Differential diagnosis, prognostic factors, and clinical treatment of proliferative Brenner tumor of the ovary.

Brenner tumors are rare ovarian tumors displaying benign, borderline or proliferative, and malignant variants. The case of a 63-year-old woman with a proliferative Brenner tumor is presented and the histomorphological differential diagnosis of this tumor entity is compared to that of its benign and malignant counterparts. Light microscopy, immunohistochemistry, and electron microscopy were performed to allow discrimination from the other subtypes. Despite a considerable overlap of pathological features the differential diagnosis of proliferative Brenner tumor could be established. Electron microscopy allowed assessment of characteristic infoldings of the nuclear membrane that proved to be a valuable ultrastructural criterion. Considering that the vast majority of Brenner tumors are benign, precise identification of the small proportion of malignant tumors allows the extent of surgical therapy to be adapted.

Biomarkers, Tumor↗

Coexisting Brenner tumor and struma ovarii in the right ovary: case report and review of the literature.

A bilateral ovarian tumor composed of mixed Brenner tumor and struma ovarii in the right ovary and mature cystic teratoma in the left ovary, is described. Mixed Brenner tumor and struma ovarii is rare; eight cases are reviewed. In this case, in addition to the typical Brenner tumor and struma ovarii, some nests composed of both Brenner tumor and struma ovarii in one nest were found in the right ovarian tumor. Immunohistochemically, the struma ovarii is stained for thyroglobulin, and Brenner nests showed various degrees of positive stain for thyroglobulin, which is a specific finding. Brenner tumor, in this case, may produce thyroglobulin or have a receptor to thyroglobulin or analog of thyroglobulin. The origin of mixed Brenner tumor and struma ovarii may be germ cell, as described in some literature, or the Brenner tumor may be of a metaplastic nature, although the Brenner tumor is fourfold the size of struma ovarii in the case presented.

Adult↗

Flow cytometric DNA analysis of ovarian Brenner tumors and transitional cell carcinomas.

Flow cytometry has been previously used as a method of obtaining prognostic information about ovarian carcinomas using ploidy, DNA index, and S-phase fraction. DNA content has also been assessed in ovarian tumors of low malignant potential. Brenner tumor variants such as metaplastic, proliferating, and low malignant potential, recently designated as intermediate Brenner tumors, and malignant Brenner tumors are unusual tumors that present classification problems. Their histological appearance may not accurately reflect biological activity. We used flow cytometry to analyze paraffin-embedded tissue for DNA content and S-phase in 34 Brenner tumors, three ovarian transitional cell (urothelial) carcinomas (TCCs), and nine normal control ovaries. We correlated histological and clinical features with DNA analysis. Twenty-five Brenner tumors and three ovarian TCCs were acceptable for histogram analysis (coefficient of variation less than 7.0). Thirteen typical, three metaplastic (extensive mucinous or glandular metaplasia), and two proliferating (papillary formation with increased cellularity) Brenner tumors were diploid. One proliferating tumor was tetraploid. The single Brenner tumor of low malignant potential was diploid but had an increased S-phase. Four of five malignant Brenner tumors were aneuploid, and one was diploid. All the TCCs were aneuploid. S-phase was elevated in intermediate and malignant Brenner tumors and TCC. Limited numbers of cases available preclude prognostic prediction based on ploidy in malignant Brenner tumors or primary ovarian TCCs. DNA ploidy and S-phase reflect the intermediate status of metaplastic, proliferating, and low malignant potential Brenner tumors.

Adult↗

The Brenner tumor: a clinicopathologic review.

The Brenner tumor of the ovary has been the topic of voluminous clinical and pathologic literature since its original description by Macnaughton-Jones in 1898. One of the major problems confronting most investigators of this uncommon neoplasm has been the question of histogenesis. There is general agreement that the tumor is derived from surface (coelomic) epithelium, as are the serous and mucinous cystadenomas. Most Brenner tumors are asymptomatic except for some which have features suggestive of estrogen production. The major pathologic variants are the proliferating and the malignant Brenner tumors; a poor prognosis is associated with the latter neoplasm. Approximately 30% of all benign Brenner tumors have a second histologic type of tumor in the ipsilateral or contralateral ovary, a serous or mucinous cystadenoma in most cases. Brenner tumors have also been reported in the broad ligament and in the testis on rare occasions.

Adult↗

Selective expression of cytokeratin polypeptides in various epithelia of human Brenner tumor.

A human ovarian Brenner tumor presenting a wide spectrum of benign and malignant histologic features was studied for its patterns of intermediate filament expression. All epithelial elements of the tumor, regardless of their morphologic type, contained cytokeratins as their only intermediate filament component. Differences were detected, however, between tumor nests that displayed transitional epithelium and those with squamoid features. These differences were manifested by the presence of cytokeratin 18, in the former type only, and by the abundance of cytokeratins 10/11 in the latter. We also detected mixed epithelial nests in which both features were present, suggesting that the transitional epithelium transforms in polar fashion into squamous epithelium. Examination of cytokeratin patterns found in urothelium and in the surface epithelium of the ovary pointed to certain differences from the Brenner tumor epithelia. The significance of these latter findings with regard to cellular transformation and histogenesis of the Brenner tumor are discussed.

Antibodies, Monoclonal↗

A histogenetic consideration of ovarian mucinous tumors based on an analysis of lesions associated with teratomas or Brenner tumors.

To investigate the histogenesis of ovarian mucinous tumors, clinicopathologic and histologic studies of mucinous tumors associated with teratomas or Brenner tumors were performed. Of 458 ovarian mucinous tumors, 13 (2.8%) and 8 (1.7%) were associated with teratomas or Brenner tumors, respectively. Of patients younger than 40 years, 5.1% had teratomas. Of patients 50 years or older, 3.5% had Brenner tumors. Histologically, nine lesions with teratomas and six lesions with Brenner tumors showed transitions or intimate admixtures of both elements. The findings of the present study suggest that teratomas and Brenner tumors make small contributions to the histogenesis of ovarian mucinous tumors but may give rise to some mucinous tumors, especially in younger patients and older patients, respectively.

Adenocarcinoma, Mucinous↗

Ovarian Brenner tumors and transitional cell carcinoma: recent developments.

Brenner tumor variants--such as metaplastic, proliferating, and low-malignant-potential (three categories recently designated as intermediate Brenner tumors)--and malignant Brenner tumors are unusual tumors presenting problems in classification. DNA ploidy and S-phase reflect the intermediate status of metaplastic, proliferating, and low-malignant-potential Brenner tumors. The category of "transitional cell carcinoma of the ovary" has been proposed for those primary ovarian carcinomas in which definite urothelial features are present, but no benign, metaplastic, and/or proliferating Brenner tumor is identified. Two subtypes have been described, the papillary and the malignant Brenner-like types. These tumors are more aggressive than malignant Brenner tumors, but they appear to respond better to chemotherapy than other types of ovarian epithelial cancer.

Brenner Tumor↗

Brenner tumor of the uterus.

Extraovarian Brenner tumors are extremely rare. Three paratesticular lesions have been observed in men. The only extraovarian Brenner tumor in a woman previously reported was located in the broad ligament. This paper describes a small tumor with histologic features of Brenner tumor within the wall of the uterus. The possible histogenesis is briefly discussed.

Brenner Tumor↗