Ovarian Malignant Brenner Tumor

Abstract

ABSTRAK Objectives: To report one malignant Brenner tumor (MBT) case in Dr. Soetomo Hospital, Surabaya, Indonesia, that underwent therapy from August 2016 to August 2017. Case report: A woman aged 62 years underwent total abdominal hysterectomy and bilateral salphingo-oophorectomy surgery with histopathologic results of malignant Brenner Tumor. From immunohistochemical examination the expression of p63 was positive. The patient had been treated with Paclitaxel carboplatin chemotherapy for 5-cycles, with the results of the last postchemotherapy evaluation showing no recidive mass. Conclusion: There was only one case of malignant ovarian Brenner Tumor in Dr Soetomo Hospital, Surabaya, Indonesia, in 2014-2016. The diagnosis can only be based on anatomic pathology examination. The specific tumor markers for malignant Brenner tumors have so far not been found. Keywords: Malignant Brenner Tumor; epithelial ovarian tumor; p63. Tujuan: Melaporkan satu kasus pasien dengan tumor Brenner di RSUD Dr. Soetomo, Surabaya, Indonesia, yang menjalani terapi dari bulan Agustus 2016 hingga Agustus 2017. Laporan kasus: Seorang wanita berusia 62 tahun menjalani histerektomi abdominal total dan operasi salphingo-ooforektomi bilateral dengan hasil histopatologis Tumor Brenner ganas. Dari pemeriksaan imunohistokimia, ekspresi p63 didapatkan positif. Pasien telah dirawat dengan kemoterapi Paclitaxel carboplatin selama 5 siklus, dengan hasil evaluasi post-kemoterapi terakhir tidak menunjukkan massa residif. Simpulan: Hanya terdapat satu kasus Tumor Brenner ovarium ganas di RSUD Dr Soetomo, Surabaya, Indonesia, antara 2014-2016. Diagnosis hanya dapat didasarkan pada pemeriksaan patologi anatomi. Penanda tumor spesifik untuk tumor Brenner ganas sejauh ini belum ditemukan. Kata kunci: Tumor Brenner ganas; tumor epitel ovarium; p63

A Rare Case of Ruptured Malignant Ovarian Brenner Tumor

“…This adjuvant chemotherapy regimen is the current standard regimen for ovarian epithelial neoplasms. The same regimen was also used in the case report by Alfianto et al [ 6 ], where after receiving 5 cycles of paclitaxel carboplatin, the patient showed no residual mass. Other regimens that can be used include monotherapies such as camptobel, gemcitabine, bevacizumab, etoposide, and Adriamycin; and combined therapies such as Taxol-cisplatin, taxol-carboplatin, hycamtin cisplatin, camptobel-carboplatin, gemcitabine-taxol-carboplatin, and docetaxel-cisplatin [ 10 ].…”

“…The exact incidence of malignant Brenner tumor (MBT) is not known. In Surabaya, Indonesia, from 2014 to 2016, MBT accounted for around 0.2% of 403 cases of ovarian epithelial cancer [ 6 ]. According to the World Health Organization (WHO), there are 3 main classification of Brenner tumors: benign, borderline, and malignant.…”

“…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.…”

“…Diagnosing malignant Brenner tumor with imaging studies such as ultrasound, CT scan, or MRI is difficult as MBT does not have any pathognomonic imaging features [ 6 , 12 ]. In our case, ultrasound examination revealed an adnexal solid mass measuring 11.86×12.50×11.24 cm, which can only conclude the presence of an ovarian tumor.…”

“…However, in advanced stages, debulking surgery, consisting of hysterectomy/bilateral salpingo-oophorectomy (BSO), shows good therapeutic outcomes. It is important to determine whether debulking surgery will benefit the patient by initially performing exploratory laparoscopic surgery [ 1 , 5 , 6 ].…”