Malignant Brenner tumor of the ovary: one single institute experience and a review of the literature

Abstract

Malignant Brenner tumors (MBT) of the ovary are rare diseases, representing 1% of all ovarian cancers and 3-5% of Brenner tumors. They carry a poor prognosis. They generally affect women during the perimenopausal and postmenopausal periods. The standard treatment is surgery; however, the indication of adjuvant chemotherapy remains controversial. The present study aims to report our experience in the treatment of MBT of the ovary, to better characterize this disease. Methods: In this study, a retrospective case series involving four patients diagnosed with MBT of the ovary and treated between 2006 and 2014. Results: Four cases of MBT of the ovary were diagnosed over a seven-year period. The mean age of our patients was 59.3±11.1 years. Three patients were in the menopause period. The tumor was staged as IC in one case, IIC in one case, and IIIC in two cases of the International Federation of Gynecology and Obstetrics classification. All patients underwent surgery, followed by adjuvant chemotherapy. Three patients underwent a loco-regional recurrence that occurred respectively, after nine months in one patient and 11 months in two patients. The treatment was based on chemotherapy combined with surgery in one case. Two patients presented distant metastasis. The treatment consisted of chemotherapy and surgery. The median follows up period was 49.0 (14.0-64.0) months. Conclusion: The treatment approach of MBT of the ovary is not well established since its scarcity and poor prognosis. Thus, more case series and meta-analysis should be conducted.

A Rare Case of Ruptured Malignant Ovarian Brenner Tumor

“…This subtype was first described by Fritz Brenner in 1907 [ 1 , 4 ]. The exact incidence of malignant Brenner tumor (MBT) is not known.…”

“…Clinical manifestations are often nonspecific and may resemble other ovarian tumors, thus causing a delay in diagnosis. Symptoms usually become more visible in advanced stages (stage III or stage IV) [ 4 – 6 ]. Bouhani et al [ 4 ] reported 4 cases of Brenner tumor, which all had nonspecific initial symptoms such as abdominal distention, abdominal pain, pelvic mass, and pelvic pain.…”

“…Symptoms usually become more visible in advanced stages (stage III or stage IV) [ 4 – 6 ]. Bouhani et al [ 4 ] reported 4 cases of Brenner tumor, which all had nonspecific initial symptoms such as abdominal distention, abdominal pain, pelvic mass, and pelvic pain. King et al [ 10 ] reported 2 cases with initial symptoms of postmenopausal bleeding and pelvic mass.…”

“…Malignant Brenner tumor does not have any specific tumor marker that can help establish its diagnosis. However, level of tumor markers, specifically CA-125, can be used to assess tumor activity and to better distinguish whether the tumor is malignant or benign [ 4 , 5 ]. A case series by Gezginc et al [ 7 ] reported that tumor marker CA-125 was increased in 13 cases of malignant Brenner tumor.…”

“…Like any other epithelial ovarian tumors, surgery is the mainstay treatment in MBT cases. The role of adjuvant chemotherapy in MBT is still being debated [ 4 , 5 ]. Herein, we report a rare case of a P0A0 woman who was diagnosed with ovarian malignant Branner tumor.…”