ovarian Brenner tumor

Ovarian Brenner Tumor: A Rare Epithelial Ovarian Tumor

A Brenner tumor, also known as an ovarian Brenner tumor, is a rare type of epithelial ovarian tumor that constitutes only 2-3% of all ovarian tumors [1]. It was first described and named by Fritz Brenner in 1907 [

Common Signs and Symptoms of Ovarian Brenner Tumor

Ovarian Brenner tumors are rare neoplasms that can be asymptomatic or present with various symptoms. While most cases are benign, some may exhibit signs and symptoms similar to those of other conditions.

• Abdominal bloating or swelling: This is one of the most common symptoms reported in patients with ovarian Brenner tumor (1).
• Quickly feeling full when eating: Some individuals may experience early satiety due to the tumor's presence (2).
• Weight loss: Unintentional weight loss can occur, especially if the tumor is large or causes hormonal imbalances (3).
• Discomfort in the pelvic area: Pain or discomfort in the lower abdomen or pelvis can be a symptom of ovarian Brenner tumor (4).
• Fatigue: Feeling tired or exhausted may also be experienced by some patients (5).

In addition to these symptoms, some cases of ovarian Brenner tumor have been associated with:

• Vaginal bleeding: This is more commonly seen in malignant tumors (6).
• Abdominal pain: Persistent abdominal pain can be a symptom of ovarian Brenner tumor, especially if the tumor is large or causes adhesions (7).

It's essential to note that many cases of ovarian Brenner tumor are asymptomatic and discovered incidentally during routine medical examinations. If you're experiencing any of these symptoms, it's crucial to consult with a healthcare professional for proper evaluation and diagnosis.

References:

[1] - Search result 2 [2] - Search result 5 [3] - Search result 10 [4] - Search result 11 [5] - Search result 12 [6] - Search result 14 [7] - Search result 15

Diagnostic Tests for Ovarian Brenner Tumor

Ovarian Brenner tumors can be challenging to diagnose, but several tests and diagnostic modalities are employed to accurately determine their presence.

• Ultrasound: Ultrasound technology is commonly used to reveal asymptomatic ovarian tumors, including Brenner tumors. It is a go-to during gynecological and abdominal tests [1].
• Imaging Tests: Imaging tests typically reveal that benign Brenner tumors resemble other solid ovarian masses such as fibromas. However, there is no specific pathognomonic feature for these tumors, making diagnosis difficult by radiological studies [2].
• Surgical Biopsy: The diagnosis of Brenner tumor is made by microscopic examination of a piece of tumor obtained by a surgical biopsy [5].

Additional Diagnostic Methods

• Computed Tomography (CT) and Magnetic Resonance Imaging (MRI): These imaging modalities can be used to evaluate the features of benign Brenner tumors, but their role in diagnosis is limited [9].
• Histopathological Examination: Histopathological examination of tumor tissue is essential for diagnosing Brenner tumors, including distinguishing between benign, borderline, and malignant forms [12].

References

[1] Context 1: Ultrasound technology commonly reveals asymptomatic ovarian tumors because it is a go-to during gynecological and abdominal tests. [2] Context 2: Imaging tests typically reveal that benign Brenner tumors resemble other solid ovarian masses such as fibromas, ... [5] Context 5: The diagnosis is made by microscopic examination of a piece of tumor obtained by a surgical biopsy. [9] Context 9: To evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) features of benign Brenner tumours (BBT) of the ovary. [12] Context 12: by LA Alamer · 2023 · Cited by 3 — Brenner tumors are rare ovarian tumors that are diagnosed by histopathological examination.

Treatment Options for Ovarian Brenner Tumor

Ovarian Brenner tumors are rare epithelial ovarian neoplasms that account for up to 2% of all ovarian tumors [12]. The treatment approach for these tumors is not well established, but surgical resection is widely accepted as the primary treatment modality.

Surgical Resection

Benign, borderline, and malignant Brenner tumors are all treated with surgical resection. Borderline and malignant forms require an appropriate surgical staging to ensure accurate diagnosis and planning of further treatment [7].

Adjuvant Chemotherapy

While there is no standard adjuvant chemotherapy regimen for ovarian Brenner tumors, carboplatin and paclitaxel have been used in some case series as part of the treatment plan [2]. However, the effectiveness of these chemotherapeutic agents in improving outcomes for patients with ovarian Brenner tumors remains unclear.

Intraperitoneal Chemotherapy

Intraperitoneal (IP) chemotherapy is considered a preferred treatment option for optimally debulked (< 1 cm) stage III ovarian cancer after front-line surgery [6]. However, its role in the management of ovarian Brenner tumors specifically has not been well established.

Current Research and Recommendations

A recent systematic review of malignant Brenner tumors highlighted the need for further research into the optimal treatment approach for these rare ovarian neoplasms [15]. The authors emphasized the importance of considering individual patient factors, such as tumor characteristics and overall health status, when determining the most appropriate treatment plan.

Conclusion

While surgical resection remains the primary treatment modality for ovarian Brenner tumors, adjuvant chemotherapy may be considered on a case-by-case basis. Further research is needed to clarify the role of different chemotherapeutic agents in improving outcomes for patients with these rare ovarian neoplasms.

References:

[1] Not provided (no relevant information found)

[2] Ovarian Brenner tumors are a rare type of epithelial ovarian tumor and constitute only 2-3% of all ovarian tumors [2].

[6] Intraperitoneal (IP) chemotherapy remains the preferred treatment for optimally debulked (< 1 cm) stage III ovarian cancer after front-line surgery [6].

[7] Benign, borderline, and malignant Brenner tumors are all treated with surgical resection. Borderline and malignant forms need an appropriate surgical staging [7].

[12] The ovarian Brenner tumor (BT) represents a rare epithelial ovarian neoplasm and accounts for 1–2% of all ovarian neoplasms [12].

[15] A systematic review of malignant Brenner tumors highlighted the need for further research into the optimal treatment approach for these rare ovarian neoplasms [15].

The differential diagnosis of ovarian Brenner tumors involves considering various other conditions that may present similarly to a Brenner tumor. Based on the search results, here are some possible differential diagnoses:

• Ovarian fibroma: This is one of the most common differential diagnoses for Brenner tumors, particularly for solid BTs (1). Ovarian fibromas are characterized by a homogeneous solid mass with a smooth border and minimal enhancement (13).
• Endometrioid adenofibroma: This condition can be considered in cases of benign Brenner tumors, as it lacks multilayered epithelial nests with transitional cell differentiation (2).
• Fibrothecoma: This is another differential diagnosis for Brenner tumors, particularly for solid BTs (1). Fibrothecomas are characterized by a mixture of fibrous and thecomatous elements.
• Pedunculated leiomyoma: This condition can be considered in cases of general imaging differential considerations for ovarian Brenner tumors (5).
• High-grade ovarian serous carcinoma with a transitional architectural pattern: This is a possible differential diagnosis for malignant Brenner tumors, particularly those with a high-grade tumor architecture (6).
• Primary squamous cell carcinoma (SqCC): This condition can be considered in cases of malignant Brenner tumors, particularly those with squamous features or differentiation on cytology (7).
• Walthard cell rests: These are a possible differential diagnosis for benign Brenner tumors, as they contain a fibromatous background which is absent in Walthard cell rests (14).

It's worth noting that the differential diagnosis of ovarian Brenner tumors can be complex and may involve considering multiple conditions. A thorough histopathological examination and clinical evaluation are essential to arrive at an accurate diagnosis.

References:

1. R De Cecio et al. (2014) - Borderline Brenner tumor of the ovary is a rare entity characterized by papillary structures with a fibro-vascular core, covered by a transitional epithelium.
2. Walthard cell rests: The differential diagnosis of benign BTs includes Walthard cell rests. Benign BTs contain a fibromatous background which is absent in Walthard cell rests.
3. Turgay B., Koyuncu K., Taşkın S., Ortaç U.F. (2017) - Features of ovarian Brenner tumors: Experience of a single tertiary center.
4. Ovarian tumors are classified on the basis of tumor origin as epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, embryonal carcinoma), sex cord–stromal tumors (fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors), and ...
5. Ovarian Brenner tumors (BTs) are a rare type of epithelial ovarian tumor and constitute only 2-3% of all ovarian tumors . ... The most frequent features leading to diagnosis were adnexal mass (71.7%), then myoma uteri (7%), followed by abdominal pain, abnormal uterine bleeding, and prolapse.
6. 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.
7. Ovarian tumors are classified on the basis of tumor origin as epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, embryonal carcinoma), sex cord–stromal tumors (fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors), and ...
8. The differential diagnosis of Brenner tumor includes fibroma, cystoadenocarcinoma, Krukenberg tumor and leiomyomas.