A Brenner tumor is a rare type of neoplasm belonging to the surface epithelial-stromal class of ovarian tumors.
Tumors (benign or malignant) under the surface epithelial-stromal umbrella are characterized by the presence of neoplastic cells (cells that divide without control or order) on the surface of the ovaries.
The surface epithelial-stromal class of tumors accounts for the majority of all ovarian cancers, which represents the fifth most deadly family of malignant neoplasm found in women. Most Brenner tumors, fortunately, are benign, but do carry with them a slight chance of becoming malignant.
Interestingly, Brenner tumors can also affect the epithelium of the testis. Such cases, though, are extremely rare.
Symptoms and Features
Brenner tumors are solid, clearly delineable growths that range in color from yellow to tan. They can grow as large as 30cm, but typically do not expand beyond a few centimeters. More than 90% of these growths originate in one ovary exclusively, leaving the other unaffected.
Most Brenner tumors are asymptomatic, meaning that the patient experiences no clear indicators that they in fact hosting an ovarian neoplasm. Thus, they are often detected incidentally during gynecological and various abdominal examinations.
Often times, with such an asymptomatic tumor, Doctors will use the term “sign” to describe a patient’s condition, not “symptom”. This distinction is made to indicate that the disease is presenting features that only a physician can recognize. One notable symptom of Brenner tumor, however infrequent, is postmenopausal bleeding.
Several tests and diagnostic modalities are employed to accurately determine the presence of a Brenner tumor:
Ultrasound technology commonly reveals asymptomatic ovarian tumors because it is a go-to during gynecological and abdominal tests. The technology utilizes high-frequency sound waves to generate images of structures within the body. It can be compared to the way that radar employs sound to detect underwater structures.
OTHER IMAGING TESTS
If an ultrasound reveals an ovarian growths, computed tomography (CT scan) and/or magnetic resonance imaging (MRI) are usually recommended by the physician in order to better understand the tumors exact size, shape, location, and rate of metastasis.
Once the tumor has been confirmed, a biopsy is often performed. This procedure involves the removal of a specimen of the neoplastic tissue to be examined under a microscope. A key diagnostic feature of a Brenner tumor is the presence of “coffee bean” shaped nuclei in the epithelium of the ovaries. These cells may also appear to have striped nuclei.
Most Brenner tumors are candidates for surgical resection. Because of their vividly circumscribed nature, they are easily located and do not typically affect surrounding tissue. Surgical resection is often curative and will reverse symptoms if they are present. Malignant Brenner tumors may affect surrounding tissue and metastasize into other structures, but such incidents are so rare that a standard treatment has not been developed.
These Brenner tumors would be treated like most cancers, with the administration of chemotherapy and/or radiation therapy. Even malignant Brenner tumors, if diagnosed early, are usually candidates for complete surgical resection.
Prognosis is usually excellent for patients with Brenner tumor. The tendency for the growth to remain benign also vastly improves morbidity and mortality rates. Malignant Brenner tumors, additionally, yield a more positive prognosis than many cancers. Furthermore, these tumors are easily located in the even of recurrence.