Malignant Brenner tumor of the ovary: Review and case report

Abstract

Ovarian neoplasms are a heterogeneous group of tumors with varying incidence in the general population. The most common are the surface epithelial tumors which include transitional cell tumors. Transitional cell tumors include both transitional cell carcinoma and Brenner tumor. The vast majority of Brenner tumors are benign, often incidental findings; however, malignant Brenner tumors (MBT) do occasionally occur. MBT present similarly to other ovarian neoplasms with abdominal pain and bulk symptoms. On imaging, these tumors demonstrate nonspecific findings. Microscopically, they demonstrate areas of conventional benign Brenner tumor juxtaposed with regions of frank malignancy showing marked cytologic atypia and infiltration. There is no consistent tumor marker for these tumors, but CA-125, CA 72-4 and SCC have been reported in singular instances. Tumors express several immunohistochemical markers of urothelial differentiation including uroplakin III, thrombomodulin, GATA3, p63, as well as cytokeratin 7. The primary treatment modality is surgical excision. Due to their rarity, the precise role and regimen of adjuvant chemo-radiation therapy for MBT has not been established. We herein review a case of MBT with emphasis on primary treatment and treatment of recurrent disease, including the use of adjuvant pelvic radiation, discuss the current state of the literature and standards of practice regarding this malignancy.

Characteristics of Peripartum Cardiomyopathy (PPCM) pregnancy and preeclampsia in Dr Soetomo Hospital, Surabaya, Indonesia, 2014-2016

“…LVEF below 25% indicates higher morbidity and mortality. 3,4,5 There were two cases with LVEF below 25%. In one case the patient died with LVEF of 23% caused by cardiogenic shock with comorbidities of PEB and Lupus Nephritis.…”

Ovarian Malignant Brenner Tumor

“…Of all the reported cases of Brenner tumor, malignant types was found in less than 5% so that until now specific management and appropriate treatment of the chemotherapy is still unclear. 4 In this case report we found one malignant Brenner tumor (MBT) case in Dr. Soetomo Hospital, Surabaya, Indonesia, who underwent therapy from August 2016 to August 2017. Retrospectively, based on the data from anatomic pathology examination results, from 2014 to 2016 there were only one malignant Brenner tumor (0.2%) of totally 403 cases ovarian epithelial cancer in Dr. Soetomo Hospital, Surabaya.…”

“…11 But TAH-BSO omentectomy and lymph node dissection in ovarian cancer patients is useful for staging based on FIGO staging. 4 In this case report, the surgery was performed RSUD Jombang hospital, and because of limited facilities the frozen section can not be performed and only TAH -BSO was performed so the stage of the cancer can not be evaluated.…”

“…This is the reason why National Comprehensive Cancer Network (NCNN) does not include radiotherapy as a primary treatment recommendation and only as a palliative radiotherapy reference to control local symptoms. 4 However, recent evidence suggests that advances in radiotherapy technology contribute to the success of locally controlling gynecological malignancies and are not associated with high rates of toxicity of the radiation.…”

Characteristics of gestational thropoblast tumor in Dr. Soetomo Hospital, year 2015-2017

“…Based on the course of the disease, GTD is divided into two namely premalignant and malignant. [1][2][3][4][5] This premalignant form of GTD is called GTN, which includes Invasive Mola, Choriocarcinoma, Trophoblastic Tumor Site (PSTT), Trophoblastic Tumor Epitheloid Tumor (ETT), and persistent or elevated levels of beta-HCG in the Hydatidiform Mole. While complete and partial hydatidiform mola are included in the premalignant GTD category.…”