Ovarian brenner tumors. I. Metaplastic, proliferating, and of low malignant potential

Abstract

In several studies, attempts were made to establish criteria for distinguishing malignant Brenner tumors from proliferating and low malignant potential ones. Although these criteria can be applied to the majority of cases, there still exist tumors that present problems in classification. In applying the World Health Organization (WHO) criteria for Brenner tumors, the most important feature for distinguishing the intermediate forms from the malignant ones is the presence of stromal invasion in the latter. This feature has generally been considered difficult to employ because of the fundamental fibroepithelial nature of Brenner tumors, the stroma being derived from the ovarian stroma. A logical and relatively easily applicable classification of Brenner tumors is presented in this report. Although more complex than the WHO classification, it includes newly recognized variants of the Brenner tumor and avoids using the same terminology to describe different types and degrees of epithelial abnormalities. Fourteen unusual Brenner tumors were studied, intermediate between typical benign and frankly malignant ones, and were classified into 3 categories representing progressive epithelial abnormalities. These include metaplastic, proliferating, and tumors of low malignant potential. In none of these does stromal invasion occur. Each of these categories corresponds to a particular urothelial abnormality or neoplasm. Through this classification, a better understanding of the morphology and biologic behavior of unusual types of Brenner tumors can be expected.

Immunohistochemical Analysis of Uroplakins, Urothelial Specific Proteins, in Ovarian Brenner Tumors, Normal Tissues, and Benign and Neoplastic Lesions of the Female Genital Tract

“…The material included five typical Brenner tumors, 16 twelve Walthard cell nests, and two of each of the following lesions: serous cyst adenoma, serous cyst adenocarcinoma, mucinous cyst adenoma, mucinous cyst adenocarcinoma, and granulosa cell tumors of the ovary, hyperplastic endometrium, endometrial adenocarcinoma, squamous cell carcinoma and adenocarcinoma of the cervix, and mesothelial inclusion cysts of the Fallopian tube. Normal urinary bladder, cervical, endometrial, myometrial, placental, Fallopian tube, and ovarian tissues were also examined.…”

Surface epithelial tumors of ovary - an analysis in a tertiary referral hospital

“…18 Twelve percent of malignant Brenner tumors are bilateral. [31][32] Transitional cell carcinomas grossly resemble other carcinomas of epithelial-stromal type, but differ from malignant Brenner tumors by lacking gritty areas of calcification, which are evident in half cases of malignant Brenner tumors. 18,33 Obviously invasive components of malignant Brenner show predominantly malignant appearing transitional cells or squamous cells and may contain mucinous cells as well.…”

Different staining patterns of ovarian Brenner tumor and the associated mucinous tumor

“…Brenner tumors with mucinous epithelium have been previously reported also as metaplastic Brenner tumor and included rare cases with a striking microcystic change [1,2]. Although literature data proposed derivation of Brenner tumors from the ovarian surface epithelium through transitional cell metaplasia [3,4], this theory has been recently challenged, and other sites of origin such as Walthard nests, teratomas, and fallopian tube epithelium have been suggested [5,6].…”