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Presented by Anna Yemelyanova, M.D. and prepared by Jeffrey T. Schowinsky, M.D.
Case 6: 45 year old woman with multicystic left ovarian mass.
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1. Question
Week 297: Case 6
45 year old woman with multicystic left ovarian mass (25.0cm). The right ovary appears normal.images/12206AY6a.jpg
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images/12206AY6e.jpgCorrect
Answer: Atypical proliferative (borderline) Brenner tumor
Histology: These are cystic masses with intraluminal friable papillary or polypoid projections. A solid (benign Brenner) component is usually present.
The tumor displays solid and papillary epithelial proliferation with mild nuclear atypia. Papillary areas lined by multilayered epithelium, and resemble low-grade urothelial carcinoma. The epithelial cells have prominent nucleoli and nuclear grooves. A benign Brenner component is usually present within the stroma adjacent to the cyst.
Discussion: Benign Brenner tumors comprise 1-2% of all ovarian neoplasms, and 3.2 % of ovarian epithelial neoplasms. They are biphasic neoplasms (adenofibromas) in which the epithelial component consists of nests of transitional-like cells. These cells are embedded in a dense, fibrous stroma.
These tumors usually occur in women older than 40 years (median age 50 years).
Most are smaller than 2.0 cm and therefore found incidentally. They are usually unilateral, but 6% are bilateral. They are slowly growing tumors that are rarely associated with ascites.Atypical proliferative (borderline) (transitional) Brenner tumors are seen in patients slightly older (mean age 60 years) than those with benign Brenner tumors. These tumors are almost always unilateral, and on average are larger than their benign counterpart (mean size 18.0 cm). The patients often present with mass-related symptoms.
Incorrect
Answer: Atypical proliferative (borderline) Brenner tumor
Histology: These are cystic masses with intraluminal friable papillary or polypoid projections. A solid (benign Brenner) component is usually present.
The tumor displays solid and papillary epithelial proliferation with mild nuclear atypia. Papillary areas lined by multilayered epithelium, and resemble low-grade urothelial carcinoma. The epithelial cells have prominent nucleoli and nuclear grooves. A benign Brenner component is usually present within the stroma adjacent to the cyst.
Discussion: Benign Brenner tumors comprise 1-2% of all ovarian neoplasms, and 3.2 % of ovarian epithelial neoplasms. They are biphasic neoplasms (adenofibromas) in which the epithelial component consists of nests of transitional-like cells. These cells are embedded in a dense, fibrous stroma.
These tumors usually occur in women older than 40 years (median age 50 years).
Most are smaller than 2.0 cm and therefore found incidentally. They are usually unilateral, but 6% are bilateral. They are slowly growing tumors that are rarely associated with ascites.Atypical proliferative (borderline) (transitional) Brenner tumors are seen in patients slightly older (mean age 60 years) than those with benign Brenner tumors. These tumors are almost always unilateral, and on average are larger than their benign counterpart (mean size 18.0 cm). The patients often present with mass-related symptoms.
