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Lou Z, Mei L, Wan Z, Zhang W, Gao J. A report of twenty cases of ovarian Brenner tumor and literature review: a case series study. BMC Womens Health 2024; 24:471. [PMID: 39192213 DOI: 10.1186/s12905-024-03316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND To explore the clinical characteristics of ovarian Brenner tumors and provide some basis for the treatment regimen of ovarian Brenner tumors. METHODS A retrospective analysis of the pathology database of surgical specimens at the Huzhou Maternal and Child Health Hospital from September 2008 to February 2023 was conducted. Patients who were pathologically diagnosed with ovarian Brenner tumors were included. Clinical data of patients was collected, and their diagnostic and treatment characteristics were summarized and analyzed. RESULTS A total of 20 cases were included in this study, all of which were histologically confirmed by surgical pathology. Among them, 8 cases (40%) were combined with serous, mucinous cystadenoma, or simple cyst. One case presented with a benign ovarian Brenner tumor combined with mucinous cystadenoma, underwent right adnexectomy, and relapsed 5 years later as a malignant Brenner tumor (MBT) coexisting with ovarian squamous cell carcinoma. Multiple tumor markers were elevated malignantly, with CA199 being the most significant. Treatments included unilateral adnexectomy in 7 cases, bilateral adnexectomy in 3 cases, total hysterectomy with bilateral adnexectomy in 7 cases, radical hysterectomy in 1 case, and 2 cases underwent ovarian staging surgery. MBT patients received three cycles of postoperative chemotherapy with the carboplatin-paclitaxel (TC) regimen. FOLLOW-UP One case with concomitant cervical cancer was lost to follow-up after surgery in an external hospital; one case with concomitant ovarian cancer received no further treatment after surgery and was lost to follow-up after 2 years; one case with concomitant endometrial cancer received no further treatment after surgery, and had no recurrence after 4 years of follow-up. Regular follow-up for MBT patients continued for 5 years without recurrence. The remaining 16 cases were followed up for a period ranging from 6 months to 7 years, with no reported recurrences. CONCLUSION Clinical manifestations and auxiliary examinations of ovarian Brenner tumors lack obvious specificity. When necessary, a combination of tumor markers and imaging examinations can aid in diagnosis. Surgical strategies should be selected according to the patient's menopausal status. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Zhaoxia Lou
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, 310000, China.
| | - Lina Mei
- Department of Internal Medicine, Huzhou Maternity & Child Health Care Hospital, Huzhou, 310000, China
| | - Zeqiu Wan
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, 310000, China
| | - Wenwen Zhang
- Department of Pathology, Huzhou Maternity & Child Health Care Hospital, Huzhou, 310000, China
| | - Jinlai Gao
- Department of Pathology, Huzhou Maternity & Child Health Care Hospital, Huzhou, 310000, China
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Brenner Tumor of the Ovary: A 10-Year Single Institution Experience and Comprehensive Review of the Literature. Med Sci (Basel) 2023; 11:medsci11010018. [PMID: 36810485 PMCID: PMC9944520 DOI: 10.3390/medsci11010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
Brenner tumors (BTs) are surface-epithelial stromal cell tumors that are categorized by the World Health Organization as benign, borderline, and malignant. Due to the rarity of BTs, the published literature on these tumors is comprised primarily of case reports and small retrospective studies. We performed a pathology database review spanning the last ten years at our institution revealing nine reported benign BTs. We collected the clinical and pathological data of patients associated with those BTs, describing the clinical presentation and imaging results, and assessing the possible risk factors associated with them. The average age at diagnosis was 58 years. BTs were discovered incidentally in 7/9 cases. The tumor was multifocal and bilateral in 1/9 cases and ranged in size from 0.2 cm to 7.5 cm. Associated Walthard rests were found in 6/9 cases and transitional metaplasia of surface ovarian and/or tubal epithelium was found in 4/9 cases. One patient had an associated mucinous cystadenoma in the ipsilateral ovary. Another patient had an associated mucinous cystadenoma in the contralateral ovary. In conclusion, we found that Walthard rests and transitional metaplasia are common findings in association with BTs. Additionally, pathologists and surgeons need to be aware of the association between mucinous cystadenomas and BTs.
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Fujita T, Takeya A, Miyata H, Ninomiya F, Nonoyama Y, Nakazawa T, Furuya Y, Enoki Y, Fujii T, Fukao S. Thoracic spinal metastasis as recurrence of borderline Brenner tumor without local recurrence: A case report. Gynecol Oncol Rep 2022; 44:101120. [PMID: 36589509 PMCID: PMC9797606 DOI: 10.1016/j.gore.2022.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Background Brenner tumor is a rare epithelial ovarian neoplasm that accounts for 2-3% of all ovarian neoplasms. Herein, we report the first case of thoracic spinal metastasis of recurrent Brenner tumor without local recurrence.Case Description.A 70-year-old female presented with a feeling of abdominal distension. Computed tomography revealed cystic lesions in her bilateral ovaries. Blood examination revealed high CA-125 [74.9 U/ml]. We excised bilateral ovaries, uterus, and omentum. Borderline Brenner tumor was diagnosed [Ki-67 labeling index: 10 %]. Follow-up abdominal echo and CA-125 examination revealed no local recurrence. 26 months later she developed paraplegia. Magnetic resonance imaging revealed tumor in the 5th-9th thoracic vertebra and compression of spinal cord at the 6th thoracic vertebra level. Her paraplegia was progressive. We performed semi-urgent partial resection of tumor and release of spinal cord compression. Spinal metastasis from Brenner tumor was diagnosed [Ki-67 labeling index: 50-60 %]. She received adjuvant radiation of 30 Gy in 10 fractions to the 4th-10th thoracic vertebra. After radiation and rehabilitation, she was discharged home on foot. She received adjuvant radiation and chemotherapy but died 11 months after spinal surgery. An autopsy has not been performed on her, and the cause of death is unknown. Conclusion We report the first case of thoracic metastasis of recurrent Brenner tumor without local recurrence.
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Affiliation(s)
- Tomoaki Fujita
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan,Corresponding author.
| | - Aya Takeya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Haruka Miyata
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Futa Ninomiya
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yutaka Nonoyama
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takuya Nakazawa
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yukiko Furuya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yasuyuki Enoki
- Department of Pathology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takashi Fujii
- Department of Radiotherapy, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Shigeharu Fukao
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
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4
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Garofalo G, Bucella D, Thomas D, Buxant F. Fertility-sparing surgery for borderline ovarian Brenner tumor and subsequent childbirth: First case report and a literature review. Clin Case Rep 2022; 10:e6609. [PMID: 36483854 PMCID: PMC9723236 DOI: 10.1002/ccr3.6609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
Borderline ovarian Brenner tumors are rare malignancies mainly diagnosed after menopause. A first pregnancy after fertility-sparing surgery by laparoscopic unilateral salpingo-oophorectomy was reported in a previous article. We now report the first baby birth after unilateral salpingo-oophorectomy for a borderline ovarian Brenner tumor and a review of the literature.
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Affiliation(s)
- Giulia Garofalo
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium
- Present address:
Erasme University Hospital, ULBBrusselsBelgium
| | - Dario Bucella
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium
- Present address:
Saint Pierre University Hospital, ULBBrusselsBelgium
| | - Dominique Thomas
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium
- Present address:
Erasme University Hospital, ULBBrusselsBelgium
| | - Frederic Buxant
- Gynaecology and Ultrasound DepartmentIxelles Hospital, Université Libre de BruxellesIxellesBelgium
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5
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Fujita T, Takeya A, Miyata H, Ninomiya F, Nonoyama Y, Nakazawa T, Furuya Y, Enoki Y, Fujii T, Fukao S. Thoracic spinal metastasis as recurrence of borderline Brenner tumor without local recurrence: A case report. Gynecol Oncol Rep 2022; 44:101108. [PMID: 36506037 PMCID: PMC9731387 DOI: 10.1016/j.gore.2022.101108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Brenner tumor is a rare epithelial ovarian neoplasm that accounts for 2-3% of all ovarian neoplasms. Herein, we report the first case of thoracic spinal metastasis of recurrent Brenner tumor without local recurrence.Case Description.A 70-year-old female presented with a feeling of abdominal distension. Computed tomography revealed cystic lesions in her bilateral ovaries. Blood examination revealed high CA-125 [74.9 U/ml]. We excised bilateral ovaries, uterus, and omentum. Borderline Brenner tumor was diagnosed [Ki-67 labeling index: 10 %]. Follow-up abdominal echo and CA-125 examination revealed no local recurrence. 26 months later she developed paraplegia. Magnetic resonance imaging revealed tumor in the 5th-9th thoracic vertebra and compression of spinal cord at the 6th thoracic vertebra level. Her paraplegia was progressive. We performed semi-urgent partial resection of tumor and release of spinal cord compression. Spinal metastasis from Brenner tumor was diagnosed [Ki-67 labeling index: 50-60 %]. She received adjuvant radiation of 30 Gy in 10 fractions to the 4th-10th thoracic vertebra. After radiation and rehabilitation, she was discharged home on foot. She received adjuvant radiation and chemotherapy but died 11 months after spinal surgery. An autopsy has not been performed on her, and the cause of death is unknown. Conclusion We report the first case of thoracic metastasis of recurrent Brenner tumor without local recurrence.
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Affiliation(s)
- Tomoaki Fujita
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan,Corresponding author.
| | - Aya Takeya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Haruka Miyata
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Futa Ninomiya
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yutaka Nonoyama
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takuya Nakazawa
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yukiko Furuya
- Department of Gynecology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Yasuyuki Enoki
- Department of Pathology, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Takashi Fujii
- Department of Radiotherapy, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
| | - Shigeharu Fukao
- Department of Neurosurgery, Kyoto Okamoto Memorial Hospital, Sayamanishinoguchi 100, Kumiyama-cho, Kuse-gun, Kyoto 613-0034 Japan
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Moreno López M, Luque González P, Gutiérrez Domingo Á, Rodríguez Jiménez I, Polo Velasco A, Jiménez Gallardo J, Pantoja Garrido M. Tumor de Brenner benigno asociado a tumor mucinoso borderline de ovario en paciente postmenopáusica. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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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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8
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Salibay CJ, Zanfagnin V, Miller H, Walia S, Brunette LL, Wang T. Borderline Brenner Tumor of the Ovary Coexisting With an Ovarian Mucinous Cystadenoma With Focal Atypical Epithelial Proliferation: A Rare Case With Review of the Literature. Int J Surg Pathol 2021; 29:788-793. [PMID: 33635096 DOI: 10.1177/1066896921999459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Ovarian Brenner tumors, accounting for ∼5% of overall ovarian epithelial neoplasm, are often reported in association with mucinous neoplasm. Histogenetically, the two tumors are thought to arise from similar precursors. To date, fewer than 60 borderline Brenner tumors alone have been reported, and the concomitant presence of atypical proliferative components in Brenner and mucinous tumors is even rarer. Therefore, the clinicopathological characteristics and prognosis of patients with the borderline Brenner tumors alone or coexisting with mucinous neoplasm are extremely limited. Herein, we report a unique case of a 53-year-old woman with a unilateral ovarian borderline Brenner tumor associated with focal atypical mucinous epithelial proliferation and her clinical presentations. The clinicopathological features of the tumor are documented and the literature review along with the clinical molecular advances are summarized in this study.
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Affiliation(s)
- Christine J Salibay
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Valentina Zanfagnin
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Heather Miller
- Department of Clinical Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Saloni Walia
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laurie L Brunette
- Department of Clinical Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Tiannan Wang
- 5116Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
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Eymerit-Morin C, Brun JL, Vabret O, Devouassoux-Shisheboran M. [Borderline ovarian tumours: CNGOF Guidelines for clinical practice - Biopathology of ovarian borderline tumors]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:629-645. [PMID: 32422414 DOI: 10.1016/j.gofs.2020.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Ovarian borderline tumors (OBT) represent a heterogeneous group of lesions with specific management for each histological subtype. Thus, the correct histological diagnosis is mandatory. MATERIAL AND METHODS References were searched by PubMed from January 2000 to January 2018 and original articles in French and English literature were selected. RESULTS AND CONCLUSIONS OBT should be classified according to the last WHO classification. Any micro-invasion (foci<5mm) or microcarcinoma (foci<5mm with nuclear atypia and desmoplastic stromal reaction) should be indicated in the pathology report. In case of serous OBT, variants (classical or the micropapillary/cribriform) should be indicated (grade C). The peritoneal implants associated with OBT, should be classified as invasive or noninvasive, according to the extension into the underlying adipous tissue. If no adipous tissue is seen the term undetermined should be used (grade B). In case of mucinous OBT bilateral and/or with peritoneal implants or peritoneal pseudomyxoma a search for primitive gastrointestinal, appendiceal or biliopancreatic tumor should be performed (grade C). In case of OBT, a thorough sampling of the tumor is recommended, with 1 block/cm and 2 blocks/cm in case of mucinous OBT, serous OBT micropapillary variant, OBT with intraepithelial carcinoma or/and micro-invasion. Peritoneal implants should be examined in toto. Omentum without macroscopic lesion should be sampled in 4 to 6 blocks (grade C). In case of ovarian cyst suspicious for OBT, fine needle aspiration is not recommended (grade C). In case of ovarian tumor suspicious for OBT, intraoperative examination should be performed by a gynecological pathologist (grade C).
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Affiliation(s)
- C Eymerit-Morin
- Service d'anatomie et cytologie pathologiques, hôpital Tenon, HUEP, UPMC Paris VI, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; Institut de pathologie de Paris, 35, boulevard Stalingrad, 92240 Malakoff, France
| | - J L Brun
- Service de chirurgie gynécologique, centre Aliénor d'Aquitaine, hôpital Pellegrin, 33076 Bordeaux, France; Société française de gynécopathologie, 94410 Saint Maurice, France
| | - O Vabret
- Service de chirurgie gynécologique, centre Aliénor d'Aquitaine, hôpital Pellegrin, 33076 Bordeaux, France
| | - M Devouassoux-Shisheboran
- Institut de pathologie multi-sites, hospices civils de Lyon, centre hospitalier Lyon Sud, centre de biologie et pathologie Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Société française de gynécopathologie, 94410 Saint Maurice, France.
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10
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Wang L, Allison D, Shukla PS. Amplification of MDM2 and Loss of p16 Expression: Do They Have a Role in Malignant Transformation of Ovarian Brenner Tumor? Am J Clin Pathol 2020; 154:133-141. [PMID: 32322877 DOI: 10.1093/ajcp/aqaa033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To review the significance of MDM2 and cyclin D1 expression and loss of p16 expression in malignant and borderline Brenner tumors (BTs) of the ovary. METHODS We describe 2 new cases of ovarian BT, 1 malignant and 1 borderline. We studied MDM2, p16, and cyclin D1 expression by immunohistochemistry in the benign, borderline, and malignant components of these 2 cases and in 5 additional cases of benign BT. We also reviewed and summarized the literature on the clinical, immunohistochemical and molecular characteristics of borderline and malignant BTs (BdBTs and MBTs). RESULTS Nuclear expression of MDM2 was seen only in the MBT. Loss of p16 expression was seen in both BdBT and MBT. Cyclin D1 expression was in proportion to the degree of malignancy. Amplification of MDM2, loss of CDKN2A (p16-encoding gene), and amplification of CCND1 (cyclin D1-encoding gene) were confirmed by commercial next-generation sequencing in the case of MBT. CONCLUSIONS We are the first to report immunohistochemical expression of MDM2 in an MBT. Amplification of MDM2 and loss of p16 expression may have a role in malignant transformation of BT.
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Affiliation(s)
- Lucy Wang
- Department of Pathology, NYU Langone Medical Center, New York, NY
| | - Douglas Allison
- Department of Pathology, NYU Langone Medical Center, New York, NY
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11
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Moret S, Just PA. [Histoseminary: Epithelial ovarian tumors - Case n o 6]. Ann Pathol 2020; 40:214-219. [PMID: 32331810 DOI: 10.1016/j.annpat.2020.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Sandrine Moret
- Service de pathologie, AP-HP, centre - université de Paris, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Pierre-Alexandre Just
- Service de pathologie, AP-HP, centre - université de Paris, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Yüksel D, Çakır C, Kimyon Cömert G, Kılıç Ç, Durmuş Y, Boran N, Boyraz G, Karalök A, Turan T. Uncommon borderline ovarian tumours: A clinicopathologic study of seventeen patients. J Turk Ger Gynecol Assoc 2019; 20:224-230. [PMID: 30178748 PMCID: PMC6883761 DOI: 10.4274/jtgga.galenos.2018.2018.0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objective To evaluate uncommon types of borderline ovarian tumors (BOT) and define the clinical, surgical, and pathologic features. Material and Methods Seventeen patients who were treated in our hospital between 1990 and 2017 were identified. Patients’ data were collected from the gynecologic oncology clinic electronic database, patients’ files, and pathology reports. Conservative surgery was defined as preservation of the uterus and at least part of one ovary. Results The mean age was 47 (range, 22-70) years. Based on histopathologic tumor type, there was mixed tumor in five (29.4%) patients, endometrioid-type in nine (52.9%), seromusinous-type in two (11.8%), and Brenner-type in one (5.9%). Conservative surgery was performed in 4 patients. Two patients with endometrioid BOT had synchronous endometrial pathology, including one (11%) patient with endometrial cancer, one (11%) with endometrial hyperplasia without atypia, and 3 (33%) patients had endometriosis. The median follow-up was 19 (range, 1-137) months. No recurrence was observed during the follow-up period. Conclusion In our small volume case series, it could be said that non-serous/non-mucinous BOT has excellent prognosis. However, endometrial pathology should be checked in endometrioid type.
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Affiliation(s)
- Dilek Yüksel
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Caner Çakır
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Günsu Kimyon Cömert
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Çiğdem Kılıç
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Yasin Durmuş
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Gökhan Boyraz
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Alper Karalök
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology Surgery, University of Health Sciences, Etlik Zübeyde Hanım Women Disease Training and Research Hospital, Ankara, Turkey
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13
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Garofalo G, Chintinne M, Thomas D, Bucella D, Buxant F. Conservative surgical treatment of a borderline ovarian Brenner tumour in a pre-menopausal woman with subsequent pregnancy: case report of a rare entity. J OBSTET GYNAECOL 2019; 40:578-579. [DOI: 10.1080/01443615.2019.1600481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Giulia Garofalo
- Department of Gynaecology, Ixelles Hospital Université Libre de Bruxelles, Bruxelles, Belgium
| | - Marie Chintinne
- Department of Pathology, Institut Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Dominique Thomas
- Department of Gynaecology, Ixelles Hospital Université Libre de Bruxelles, Bruxelles, Belgium
| | - Dario Bucella
- Department of Gynaecology, Ixelles Hospital Université Libre de Bruxelles, Bruxelles, Belgium
| | - Frederic Buxant
- Department of Gynaecology, Ixelles Hospital Université Libre de Bruxelles, Bruxelles, Belgium
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Abstract
Brenner tumors arise from ovarian epithelium, accounting for approximately 5% of benign ovarian epithelial tumors. The World Health Organization classification groups them into benign, borderline, and malignant on the basis of proliferation and invasiveness, and borderline Brenner tumor is defined as “displaying epithelial proliferation beyond that seen in benign Brenner's tumor, but lacking stromal invasion.” Borderline Brenner tumors are rare. Fewer than 60 cases have been reported. The more recent articles mostly focus on pathogenesis. We reviewed the literature on borderline Brenner tumor and have summarized the clinical and pathologic findings, as well as the treatment, differential diagnoses, and recent advances in histogenesis and molecular pathogenesis.
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Affiliation(s)
- Ruifang Zheng
- From the Department of Pathology, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Debra S. Heller
- From the Department of Pathology, Rutgers-New Jersey Medical School, Newark, New Jersey
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15
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Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria. Virchows Arch 2016; 470:125-142. [PMID: 28025670 PMCID: PMC5298321 DOI: 10.1007/s00428-016-2040-8] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 12/20/2022]
Abstract
Borderline ovarian tumors (BOT) are uncommon but not rare epithelial ovarian neoplasms, intermediate between benign and malignant categories. Since BOT were first identified >40 years ago, they have inspired controversies disproportionate to their incidence. This review discusses diagnostic criteria for the histologic subtypes of BOT, highlighting areas of diagnostic challenges, ongoing controversies, and changes in terminology implemented by the recent 2014 WHO Classification of Tumours of the Female Genital Organs. Emerging knowledge supports the notion that subtypes of borderline ovarian tumors comprise distinct biologic, pathogenetic, and molecular entities, precluding a single unifying concept for BOT. Serous borderline tumors (SBT) share molecular and genetic alterations with low-grade serous carcinomas and can present at higher stages with peritoneal implants and/or lymph node involvement, which validates their borderline malignant potential. All other (non-serous) subtypes of BOT commonly present at stage I confined to the ovary(ies) and are associated with overall survival approaching that of the general population. An important change in the WHO 2014 classification is the new terminology of non-invasive implants associated with SBT, as any invasive foci (previously called “invasive implants”) are now in line with their biological behavior considered peritoneal low-grade serous carcinoma (LGSC). The controversy regarding the terminology of non-serous borderline tumors, called by some pathologists “atypical proliferative tumor” in view of their largely benign behavior, has not been resolved. The concepts of intraepithelial carcinoma and microinvasion may evolve in further studies, as their presence appears to have no prognostic impact and is subject to considerable inter-observer variability.
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16
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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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17
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Braicu EI, Van Gorp T, Nassir M, Richter R, Chekerov R, Gasimli K, Timmerman D, Vergote I, Sehouli J. Preoperative HE4 and ROMA values do not improve the CA125 diagnostic value for borderline tumors of the ovary (BOT) - a study of the TOC Consortium. J Ovarian Res 2014; 7:49. [PMID: 24872845 PMCID: PMC4024312 DOI: 10.1186/1757-2215-7-49] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/30/2014] [Indexed: 11/28/2022] Open
Abstract
Background Borderline tumors of the ovary (BOT) are a distinct entity of ovarian tumors, characterized by lack of stromal invasion. Recent studies postulated that the presence of invasive implants, incomplete staging, fertility sparing surgery and residual tumor after surgery are major prognostic factors for BOT. There are no biomarkers that can predict BOT or the presence of invasive implants. Objective The aim of our study was to assess the value of CA125 and HE4 alone, or within ROMA score for detecting BOT, and for predicting the presence of invasive implants. Methods Retrospective, monocentric study on 167 women diagnosed with BOT or benign ovarian masses. Serum HE4, CA125 levels and ROMA were assessed preoperatively. Due to low number of BOT with invasive implants, we performed an unmatched analysis (consecutive patients) and a matched analysis (according to age and histology) to compare BOT with invasive implants, BOT without invasive implants and benign disease. Results There were no significant differences in the HE4 and CA125 expressions in the three groups of patients (p = 0.984 and p = 0.141, respectively). The ROC analysis showed that CA125 alone is superior to ROMA and HE4 in discriminating patients with BOT with invasive implants from patients with benign diseases and BOT without invasive implants. A newly established score, ROMABOT, did not perform better than ROMA. The analysis of the matched groups revealed similar results as the analysis of all samples. Conclusions Both HE4 and CA125 are not reliable biomarkers for the diagnosis of BOT or for predicting the presence of invasive implants.
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Affiliation(s)
- Elena Ioana Braicu
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Toon Van Gorp
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre, PO Box 5800, Maastricht 6202 AZ, The Netherlands
| | - Mani Nassir
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Rolf Richter
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Radoslav Chekerov
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Khayal Gasimli
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
| | - Dirk Timmerman
- Department of Obstetrics and Gynecology, University Hospital KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Ignace Vergote
- Department of Obstetrics and Gynecology, University Hospital KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Jalid Sehouli
- Department of Gynecology, Campus Virchow Clinic, Charité Medical University Berlin, Augustenburger Platz 1, Berlin 13353, Germany
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