Adult ; Brenner Tumor ; complications ; diagnostic imaging ; Female ; Humans ; Psoas Abscess ; diagnosis ; diagnostic imaging ; etiology ; Radiography

OBJECTIVETo assess clinical and pathological features of ovarian transitional cell tumors.

METHODSFourteen cases of ovarian transitional cell carcinoma (TCC) were selected and investigated for their clinical and pathological features. Their immunohistochemical profiles were compared with 12 cases of serous adenocarcinoma (SC) admixed with TCC and 4 cases of EC admixed with TCC 20 cases of pure high-grade serous adenocarcinoma (HG-SC), 15 cases of endometrioid adenocarcinoma (EC), 6 cases of Brenner tumor (BT, 2 cases of malignant BT and 4 cases of benign BT).

RESULTSThe patients' age ranged from 36-63 years (mean, 56 years). All cases underwent surgery and postoperative chemotherapy with TP or CAP program. Clinical follow-up was available in 9 cases, of which 2 patients died. Histologically, all cases showed features of transitional cell carcinoma without BT component. Immunohistochemically, 13 of 14 TCCs were positive for WT-1 and all were positive for CK7, ER, PR and CA125, but negative for Uroplakin III and CK20.Similar immunohistochemical staining patterns were seen in SC admixed with TCC and pure HG-SC. Percentage of the 14 TCC cases were also diffusely positive for BRCA1. All SCs admixed with TCC and pure HG-SCs were diffusely or heterogeneously positive for WT-1, with a sharp contrast and mottled distribution pattern in the heterogeneous cases. All TCCs were diffusely and strongly positive for p53, while 16 of 20 cases of pure HG-SC were positive. The positive ratio of p53 in SCs admixed with TCC cases was 11/12.WT-1 expression in TCCs was significantly higher than BTs, ECs and ECs admixed with TCC (P < 0.01), while no obvious difference was seen when compared with SCs admixed with TCC and pure HG-SCs.SCs admixed with TCC, TCCs and EC were positive for BRCA1 except pure ECs and BTs. The positive rate of Ki-67 of BTs was low, while it was higher in TCCs, SCs admixed with TCC and pure HG-SCs. Only BTs expressed Uroplakin III.

CONCLUSIONSOvarian TCC has characteristic morphological and immunohistochemical features, similar to SC but different from BT. Therefore, TCC should be considered as a morphological variant of HG-SC.

Adult ; Brenner Tumor ; metabolism ; pathology ; CA-125 Antigen ; metabolism ; Carcinoma, Endometrioid ; pathology ; Carcinoma, Transitional Cell ; pathology ; Cystadenocarcinoma, Serous ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasms, Glandular and Epithelial ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; Uroplakin III ; metabolism

Adenocarcinoma, Clear Cell ; etiology ; pathology ; Brenner Tumor ; etiology ; pathology ; Carcinosarcoma ; etiology ; pathology ; Cell Transformation, Neoplastic ; Cystadenocarcinoma, Serous ; etiology ; pathology ; Epithelial Cells ; metabolism ; pathology ; Female ; Genes, p53 ; Humans ; Mutation ; Neoplasms, Glandular and Epithelial ; etiology ; genetics ; metabolism ; pathology ; Ovarian Neoplasms ; etiology ; genetics ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; genetics ; metabolism

Herein, we present two cases of Brenner tumor, a rarely occurring neoplasm in the ovaries, obtained via intraoperative fine needle aspiration. The borderline Brenner tumor exhibited marked squamous metaplasia, characterized by individually distributed atypical squamous cells. A benign Brenner tumor associated with mucinous cystadenoma evidenced typical mucinous metaplastic features and transitional foci. These distinctive features may prove helpful in differential diagnosis of varied ovarian tumors, and particularly for intraoperative consultation.
Biopsy, Fine-Needle ; Brenner Tumor ; Cystadenoma, Mucinous ; Diagnosis, Differential ; Female ; Metaplasia ; Mucins ; Ovary

OBJECTIVEIn order to improve the preoperative diagnostic accuracy, the computed tomographic (CT) features of ovarian Brenner tumor were described and analyzed.

METHODSCT image and clinical data of nine patients with pathologically confirmed Brenner tumor were collected and analyzed retrospectively. There were 8 benign lesions and 1 borderline lesion.

RESULTSAll lesions in the nine cases were unilateral, round, lobulated or irregular in shape and well defined, in a mean diameter of 7.8 cm. Among the nine cases, 5 were benign tumors with uniform structure, 3 were benign tumors accompanied with other pathological components, and 1 was borderline tumor. On the CT images, the 5 uniform benign lesions showed to be solid tumor of low density (lower than that of muscle) or with small cyst inside, two of the 5 lesions had calcification, and other 2 lesions showed slightly heterogeneous enhancement after enhanced scanning. The 3 benign Brenner tumors accompanied with other pathological structures were solid-cystic or cystic, with a clear demarcation of solid and cystic components. The density of solid parts was lower than that of muscle, and slight enhancement, and one of them had calcification. The one borderline tumor was a heterogeneous solid one and its density was higher than that of muscle, with a large proportion of low density and large calcification, and moderately enhanced after enhancing. None of the 9 cases had metastasis or effusion.

CONCLUSIONOvarian Brenner tumors are usually unilateral and often accompanied with other type of tumor components. When a tumor is of uniform component, the CT imaging often shows a homogeneous solid tumor with homogeneous or heterogeneous density. When a tumor is accompanied with other tumor components, it may be solid-cystic or cystic and has partial calcification. After enhancing, a benign Brenner tumor is slightly enhanced, while the borderline one is moderately/highly enhanced.

Aged ; Brenner Tumor ; diagnosis ; diagnostic imaging ; Carcinoma, Transitional Cell ; diagnosis ; Cystadenoma, Mucinous ; diagnostic imaging ; Cystadenoma, Serous ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; diagnostic imaging ; Ovary ; diagnostic imaging ; Sex Cord-Gonadal Stromal Tumors ; diagnosis ; Tomography, Spiral Computed ; methods

Aged ; Anion Exchange Protein 1, Erythrocyte ; metabolism ; Brenner Tumor ; metabolism ; pathology ; surgery ; Carcinoma, Transitional Cell ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Cystectomy ; Female ; Humans ; Hysterectomy ; Membrane Proteins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Urinary Bladder Neoplasms ; metabolism ; pathology ; surgery

Co-existing Brenner tumor and struma ovarii in the unilateral ovary is very rare. The present case, which is the first case in Korea, and to our knowledge only nine cases had been reported in other countries. We report a case of 42-year-old woman who had co-existing Brenner tumor and struma ovarii in the unilateral ovary with a brief review of the literature.
Adult ; Brenner Tumor ; Female ; Humans ; Korea ; Ovary ; Struma Ovarii

Primary ovarian transitional cell carcinoma (TCC) is extremely rare type of tumor and resembles transitional cell carcinoma of the bladder. Primary ovarian TCC has been classified as a different subtype from malignant Brenner tumor for it's histologic and clinical characteristics. It usually presents at an advanced stage .Though more aggressive than malignant Brenner tumor, it shows more favorable prognosis because of better response to the chemotherapy than other epithelial ovarian carcinomas. We experienced a case of primary ovarian transitional cell carcinoma in a premenopausal woman who underwent staging operation and chemotherapeutic treatment, and herein report the case with a brief review of related literatures.
Brenner Tumor ; Carcinoma, Transitional Cell ; Female ; Humans ; Ovary ; Prognosis ; Urinary Bladder

Adult ; Brenner Tumor ; diagnosis ; pathology ; Female ; Humans ; Ovarian Neoplasms ; diagnosis ; pathology ; Ovary ; pathology ; surgery

The Brenner tumors of the ovary are uncommon and constitute 1.5-2.5% of all ovarian neoplasms. And their malignant counterparts are rare. Although the first malignant Brenner tumor was described by Von Numers in 1945, only a few malignant Brenner tumors have been reported. The definition and its biologic behavior, and the optimal treatment has not been established. We present a patient who had total abdominal hysterectomy with unilateral salpingooophorectomy due to adenomyosis. The resected ovary had only follicular cysts and the remained ovary was grossly normal . Malignant Brenner tumor developed at the remained ovary 15 years after operation. Operation and adjuvant chemotherapy was applied and patient is alive without evidence of disease. We have experienced a case of malignant Brenner tumor developed at the remained ovary after contralateral oophorectomy with a brief review of literature.
Adenomyosis ; Brenner Tumor* ; Chemotherapy, Adjuvant ; Female ; Follicular Cyst ; Humans ; Hysterectomy ; Ovarian Neoplasms ; Ovariectomy* ; Ovary*