Journal of International Obstetrics and Gynecology

Journal of International Obstetrics and Gynecology ›› 2024, Vol. 51 ›› Issue (5): 578-583.doi: 10.12280/gjfckx.20240491

• Research on Gynecological Malignancies: Original Article • Previous Articles     Next Articles

Five Cases of Diagnosis and Treatment of Ovarian Brenner Tumors

JIN Xiao-lei, XU Fei-xue()   

  1. The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China (JIN Xiao-lei); Department of Obstetrics and Gynecology, The First Hospital of Lanzhou University, Key Laboratory of Gynecological Tumor of Gansu Province, Lanzhou 730000, China (XU Fei-xue)
  • Received:2024-05-27 Published:2024-10-15 Online:2024-10-17
  • Contact: XU Fei-xue, E-mail: xfx.sxq@163.com

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Abstract:

Objective: To summarize the clinical features, pathological characteristics, and treatment of ovarian Brenner tumors. Methods: A retrospective analysis was performed on the clinical data of five patients who underwent surgery and were subsequently diagnosed with ovarian Brenner tumors through postoperative paraffin pathology at the First Hospital of Lanzhou University from January 2000 to December 2023. We aimed to summarize their clinical features, pathological characteristics, and treatment experiences. Results: The ages of the five patients ranged from 46 to 72 years, with a median age of 70 years. The body mass index (BMI) ranged from 19.11 to 28.77 kg/m2, with a median BMI of 25.64 kg/m2. Among them, two cases were classified as borderline Brenner tumors (BdBT) and three as malignant Brenner tumors (MBT). Two patients with MBT exhibited significantly elevated carbohydrate antigen 125 (CA125) levels. All five patients had a maximum tumor diameter greater than 2 cm, and all tumors were unilateral. Imaging results indicated cystic solid lesions. Microscopic examination revealed that the ovarian BdBT consisted of transitional cell epithelium nests and fibrous stroma, with increased cellular layers and atypical nuclei but no stromal invasion. The cells in ovarian MBT showed pronounced atypia, and the cytoplasm was eosinophilic or clear, with infiltrative growth of tumor tissues. All five patients tested positive for cytokeratin 7 (CK7), GATA3, and P63, while CK20 and Wilms tumor gene 1 (WT1) were negative. The Ki-67 proliferation index was less than 5% in one BdBT patient, while the remaining four patients had a Ki-67 index of approximately 20% to 40%. All five patients underwent surgical treatment, and two patients received adjunctive chemotherapy. Except for one patient with ovarian MBT who was lost to follow-up, the other four patients remained alive without recurrence during the follow-up period. Conclusions: Preoperative imaging and CA125 tests have no definitive diagnostic value for ovarian Brenner tumors, which should be diagnosed based on histopathological and immunohistochemical examinations. The differentiation between MBT and BdBT lies in the degree of cellular atypia and the presence or absence of stromal invasion. Surgery is the primary treatment modality for ovarian Brenner tumors.

Key words: Brenner tumor, Ovarian neoplasms, Immunohistochemistry, Pathology, Diagnosis