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Ricotta G, Maulard A, Genestie C, Pautier P, Leary A, Chargari C, Candiani M, Morice P, Gouy S. Brenner Borderline Ovarian Tumor: A Case Series and Literature Review. Ann Surg Oncol 2021; 28:6714-6720. [PMID: 33768396 DOI: 10.1245/s10434-021-09879-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Most frequent borderline ovarian tumors are serous and mucinous subtypes. Less frequent borderline diseases are endometrioid, clear-cell, and Brenner tumors (BBOT). Very little is known about the latter subtype, and most studies include very short series or case reports. The aim of this study is to determine the prognosis of a continuous series of BBOT and analyze data published in the literature on this rare entity. PATIENTS AND METHODS A retrospective review of patients with BBOT treated or referred to our institutions was conducted. A centralized histological review by a reference pathologist and data on the clinical characteristics, management, and outcomes of patients were required for inclusion. RESULTS Overall, 17 patients were identified. Median age was 62 (range 42-85) years. Six patients underwent unilateral salpingo-oophorectomy, and 11 bilateral salpingo-oophorectomy +/- hysterectomy and/or staging surgery. In total, 16 patients had unilateral tumor, and all patients had stage I disease. Stromal microinvasion was observed in three cases. Median follow-up was 60 months (range 7-118 months). One patient developed a recurrence in contralateral ovary after unilateral salpingo-oophorectomy. One patient had previous history of urothelial tumor. CONCLUSIONS Peritoneal staging surgery is not required because all patients reported had stage I disease. One recurrence occurred. When reviewing all the 82 cases reported in the literature (including ours), 9% had previous history or synchronous urothelial tumor, suggesting the need to carefully check for urological disease in patients with BBOT.
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Affiliation(s)
- Giulio Ricotta
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
| | - Amandine Maulard
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
| | | | - Patricia Pautier
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Alexandra Leary
- Department of Medical Oncology, Gustave-Roussy, Villejuif, France
| | - Cyrus Chargari
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - Massimo Candiani
- IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Philippe Morice
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France. .,Paris Sud University, Kremlin Bicetre, France.
| | - Sebastien Gouy
- Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France
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Parcesepe P, Coppola L, Remo A, D’Andrea MR, Coppola G, Simbolo M, Manfrin E, Scarpa A, De Santis E, Giordano G. Molecular and Clinical Insights in Malignant Brenner Tumor of the Testis With Liver Metastases:A Case Report. Front Oncol 2021; 11:663489. [PMID: 33912469 PMCID: PMC8072450 DOI: 10.3389/fonc.2021.663489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/25/2021] [Indexed: 02/05/2023] Open
Abstract
Malignant Brenner Tumor (mBT) is extremely rare. Although BT are almost exclusive ovarian neoplasms, they may constitute a highly unusual tumor of the testis; in fact, only seven fully documented cases have been reported to date. Because of their rarity, the pathogenesis of these tumors has not been clarified and there is no standard therapeutic approach. We report the first case of epididymal mBT with synchronous, multiple, liver metastases and a very dramatic clinical course. Both primary tumor and metastasis were subjected to mutational analysis of 20 cancer associated genes. Primary tumor showed FGFR3 Tyr375Cys and PIK3CA His1047Arg missense mutations. Both mutations are reported as pathogenic in ClinVar database. The same FGFR3 mutation was present in liver metastasis. Based on these results we believe that the FGFR pathway could be an ideal candidate for personalized treatment, offering hope to a subset of patients with mBT. Personalized approach, including mutational analysis and molecular testing should be required in patients with rare tumors in order to clarify diagnosis and improve therapeutic strategies.
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Affiliation(s)
- Pietro Parcesepe
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- *Correspondence: Pietro Parcesepe, ; Guido Giordano,
| | - Luigi Coppola
- Unità Operativa Complessa (UOC) Anatomia ed Istologia Patologica e Citologia Diagnostica, Dipartimento dei Servizi Diagnostici e della Farmaceutica, Ospedale Sandro Pertini, Roma, Italy
| | - Andrea Remo
- Pathology Unit, “Mater Salutis” Hospital, Legnago, Italy
| | - Mario Rosario D’Andrea
- Unità Operativa Semplice a valenza Dipartimentale (UOSD) Oncologia, Ospedale S. Paolo, Civitavecchia, Italy
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Michele Simbolo
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | - Erminia Manfrin
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Polilinico Riuniti, Foggia, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Pietro Parcesepe, ; Guido Giordano,
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Gupta R, Bhatia S, Bajaj SK. Malignant Brenner Tumor: Rare Case Report and Review of Literature. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2017. [DOI: 10.1007/s40944-017-0146-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Turgay B, Koyuncu K, Taşkın S, Ortaç UF. Features of ovarian Brenner tumors: Experience of a single tertiary center. Turk J Obstet Gynecol 2017; 14:133-137. [PMID: 28913150 PMCID: PMC5558414 DOI: 10.4274/tjod.98216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/15/2017] [Indexed: 12/01/2022] Open
Abstract
Objective: Brenner tumors are rare neoplasms of the ovary. The aim of this study was to investigate the clinical features of Brenner tumors. Materials and Methods: The clinical features of 22 patients who were treated in Ankara University Faculty of Medicine Obstetrics and Gynecology Department between 2005 and 2015 were evaluated retrospectively from hospital medical records. Results: The patients were aged 34 to 79 years at the time of diagnosis and the mean age was 55.1 years. Two (9.1%) patients were pre-menopausal, five (22.7%) were peri-menopausal, and 25 (68.2%) patients were postmenopausal. One patient was pregnant. Twenty of the neoplasms were benign, one was malignant, and one was both malignant and benign. There was no recurrence in the malignant cases. Six (27.2%) patients had mixed tumors consisting of Brenner tumor and another ovarian pathology. Specifically, the other component of these tumors was mucinous cystadenoma in four patients, endometriosis externa in one patient, and high-grade serous papillary cyst adenocarcinoma in one patient. Conclusion: Brenner tumors are usually incidental benign pathologic findings of surgical procedures in postmenopausal women. They can be found with other ovarian pathologies such as mucinous ovarian tumors and can coexist with other female genital tumors. Further studies are needed to completely understand the clinical features of Brenner tumors.
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Affiliation(s)
- Batuhan Turgay
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Kazibe Koyuncu
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Salih Taşkın
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Uğur Fırat Ortaç
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
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De Cecio R, Cantile M, Collina F, Marra L, Santonastaso C, Scaffa C, Botti G, Losito NS. Borderline Brenner tumor of the ovary: a case report with immunohistochemical and molecular study. J Ovarian Res 2014; 7:101. [PMID: 25358264 PMCID: PMC4226905 DOI: 10.1186/s13048-014-0101-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 10/15/2014] [Indexed: 11/21/2022] Open
Abstract
Background Borderline Brenner tumor of the ovary is a rare entity characterized by papillary structures with a fibro-vascular core, covered by a transitional epithelium, and by the absence of stromal infiltration. It is associated, by definition, with a benign component of Brenner tumor. Case We report a case of a 68-year-old woman, with a right ovarian mass, whose morphology and immuno-profile were consistent with the diagnosis of a borderline Brenner tumor. Immunohistochemistry carried out on selected markers may help to formulate the diagnosis, more than the molecular analyses. Electronic supplementary material The online version of this article (doi:10.1186/s13048-014-0101-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rossella De Cecio
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Monica Cantile
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Francesca Collina
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Laura Marra
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Clemente Santonastaso
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Cono Scaffa
- Department of Gynecologic Oncology, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
| | - Nunzia Simona Losito
- Pathology Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", via Mariano Semmola, 80131, Napoli, Italy.
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Dierickx I, Valentin L, Van Holsbeke C, Jacomen G, Lissoni AA, Licameli A, Testa A, Bourne T, Timmerman D. Imaging in gynecological disease (7): clinical and ultrasound features of Brenner tumors of the ovary. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2012; 40:706-713. [PMID: 22407678 DOI: 10.1002/uog.11149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/24/2012] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To describe clinical and ultrasound features of Brenner tumors of the ovary. METHODS In this retrospective study, the databases of the International Ovarian Tumor Analysis (IOTA) studies and one tertiary center were searched to identify patients who had undergone an ultrasound scan before surgery for an adnexal mass that proved to be a Brenner tumor. Twenty-eight patients with 29 Brenner tumors were included, most of which had been collected within the framework of the IOTA studies. An experienced ultrasound examiner reviewed available ultrasound images (available for 14 tumors), searching for a pattern specific to Brenner tumors. RESULTS Most patients were postmenopausal and asymptomatic. Twenty-four (83%) tumors were benign, two (7%) were borderline and three (10%) were malignant. Most benign tumors (17/24, 71%) contained solid components and manifested no or minimal blood flow on Doppler examination (19/24, 79%). Information about calcifications was available for 15 benign tumors, and in 13 (87%) calcifications were present. The five borderline and invasively malignant tumors contained solid components less often than did the benign ones (3/5, 60%) and were more richly vascularized on Doppler examination. Information about calcifications was available for four borderline or invasively malignant tumors, and in three (75%) calcifications were present. CONCLUSION We failed to demonstrate ultrasound features specific to Brenner tumors. A prospective study is needed to determine if ultrasound features of calcifications can discriminate between Brenner tumors and other types of ovarian tumor.
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Affiliation(s)
- I Dierickx
- Department of Obstetrics and Gynecology, Algemeen Ziekenhuis Sint-Lucas, Gent, Belgium
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Gezginç K, Karatayli R, Yazici F, Acar A, Çelik Ç, Çapar M, Tavli L. Malignant Brenner tumor of the ovary: analysis of 13 cases. Int J Clin Oncol 2011; 17:324-9. [DOI: 10.1007/s10147-011-0290-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 07/04/2011] [Indexed: 11/28/2022]
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A borderline ovarian Brenner tumor mimicks uterine fibroids. Taiwan J Obstet Gynecol 2011; 50:103-5. [DOI: 10.1016/j.tjog.2009.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2009] [Indexed: 11/17/2022] Open
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Transitional cell tumor of the ovary: computed tomographic and magnetic resonance imaging features with pathological correlation. J Comput Assist Tomogr 2009; 33:106-12. [PMID: 19188796 DOI: 10.1097/rct.0b013e3181638121] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe computed tomographic (CT) and magnetic resonance (MR) imaging findings of transitional cell tumors, including newly established transitional cell carcinoma, according to tumor type with pathological correlation. METHODS We retrospectively reviewed the CT and MR images of 22 patients with transitional cell tumors of ovary (14 benign Brenner, 2 borderline Brenner, 2 malignant Brenner, and 4 transitional cell carcinomas) for the following factors: size, location, configuration, signal intensity, staging, and accompanying ovarian tumors. RESULTS Sixteen tumors were detected on CT or MRI (8 benign, 2 borderline, and 6 malignant tumors), and the mean size of measurable tumors was 8.8 cm. Benign Brenner tumors were homogeneous solid (n = 6) or unilocular cystic (n = 2). Two borderline Brenner tumors were multilocular cystic. Malignant tumors, including malignant Brenner tumors and transitional cell carcinomas, were heterogeneous solid (n = 3) or multilocular cystic (n = 3). The signal intensity of solid components on T2-weighted images was isointense compared with that of muscle in benign and borderline Brenner tumors and hyperintense in malignant tumors. CONCLUSIONS The CT and MR appearance of transitional cell tumors varied according to tumor type. Benign Brenner tumors were homogeneous solid or unilocular cystic pattern, and malignant tumors were heterogeneous solid or multilocular cystic.
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Angeles-Angeles A, Gutiérrez-Villalobos LI, Lome-Maldonado C, Jiménez-Moreno A. Polypoid Brenner tumor of the uterus. Int J Gynecol Pathol 2002; 21:86-7. [PMID: 11781531 DOI: 10.1097/00004347-200201000-00017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Extraovarian Brenner tumors (BT) are very rare. We report such a tumor that was an intracavitary polyp in the uterus of a 63-year-old woman. The differential diagnosis included a pure transitional cell tumor, a mixed mullerian tumor, and a uterine tumor resembling an ovarian sex cord tumor. The histogenesis of BT remains controversial; in this particular case the location of the BT suggests a mullerian origin.
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Affiliation(s)
- Arturo Angeles-Angeles
- Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F
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