Brenner Tumour
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Brenner tumors are an uncommon subtype of the surface epithelial-stromal tumor group of ovarian neoplasms. The majority are
benign Malignancy () is the tendency of a medical condition to become progressively worse. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not s ...
, but some can be
malignant Malignancy () is the tendency of a medical condition to become progressively worse. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not s ...
. They are most frequently found incidentally on pelvic examination or at
laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ane ...
. Brenner tumours very rarely can occur in other locations, including the
testes A testicle or testis (plural testes) is the male reproductive gland or gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testes are to produce both sperm and androgens, primarily testoste ...
.


Presentation

On gross
pathological Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in th ...
examination, they are solid, sharply circumscribed and pale yellow-tan in colour. 90% are unilateral (arising in one ovary, the other is unaffected). The tumours can vary in size from less than to . Borderline and malignant Brenner tumours are possible but each are rare.


Diagnosis

Histologically Histology, also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vis ...
, there are nests of
transitional epithelial Transitional epithelium also known as urothelium is a type of stratified epithelium. Transitional epithelium is a type of tissue that changes shape in response to stretching (stretchable epithelium). The transitional epithelium usually appears ...
(
urothelial Transitional epithelium also known as urothelium is a type of stratified epithelium. Transitional epithelium is a type of tissue that changes shape in response to stretching (stretchable epithelium). The transitional epithelium usually appears ...
) cells with longitudinal nuclear grooves (
coffee Coffee is a drink prepared from roasted coffee beans. Darkly colored, bitter, and slightly acidic, coffee has a stimulating effect on humans, primarily due to its caffeine content. It is the most popular hot drink in the world. Seeds of ...
bean nuclei) lying in abundant fibrous stroma. Also recall that the "coffee bean nuclei" are the nuclear grooves exceptionally pathognomonic to the sex cord stromal tumor, the ovarian granulosa cell tumor, with the fluid-filled spaces
Call–Exner bodies Call–Exner bodies, giving a follicle-like appearance, are small eosinophilic fluid-filled punched out spaces between granulosa cells. The granulosa cells are usually arranged haphazardly around the space. They are pathognomonic for granulosa c ...
between the granulosa cells.


Similar conditions

Transitional cell carcinoma is an even rarer entity, in which neoplastic transitional epithelial cells similar to transitional cell carcinoma of the bladder are seen in the ovary, without the characteristic stromal/epithelial pattern of a Brenner tumour. Histologically, Leydig cell tumors of the testes and ovarian stromal Leydig cell tumors (ovarian hyperandrogenism and virilization) both have characteristic
Reinke crystals Reinke crystals are rod-like cytoplasmic inclusions which can be found in Leydig cells of the testes. Occurring only in adult humans and wild bush rats, their function is unknown. Ovarian stromal tumors having a predominant pattern of fibroma or t ...
. The same crystals were also noted under high power view in Brenner tumor

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Eponym

It is named for Fritz Brenner (pathologist), Fritz Brenner (1877–1969), a German surgeon who characterized it in 1907. The term "Brenner tumor" was first used by
Robert Meyer Robert Meyer (born October 2, 1945 in Oslo, Norway) is a Norwegian art photographer, professor, photo historian, collector, writer and publicist. He is the son of journalist Robert Castberg Meyer and homemaker Edel Nielsen; and brother of the in ...
, in 1932.


Additional images

File:Walthard cell rest - very high mag.jpg,
Micrograph A micrograph or photomicrograph is a photograph or digital image taken through a microscope or similar device to show a magnified image of an object. This is opposed to a macrograph or photomacrograph, an image which is also taken on a m ...
of a
Walthard cell nest Walthard cell rests, sometimes called Walthard cell nests, are a benign cluster of epithelial cells most commonly found in the connective tissue of the Fallopian tubes, but also seen in the mesovarium, mesosalpinx and ovarian hilus. Appearance ...
, the entity Brenner tumours are thought to arise from.
H&E stain Hematoxylin and eosin stain ( or haematoxylin and eosin stain or hematoxylin-eosin stain; often abbreviated as H&E stain or HE stain) is one of the principal tissue stains used in histology. It is the most widely used stain in medical diagnos ...
.


References


External links

*
Histology
at
University of Utah The University of Utah (U of U, UofU, or simply The U) is a public research university in Salt Lake City, Utah. It is the flagship institution of the Utah System of Higher Education. The university was established in 1850 as the University of De ...
{{DEFAULTSORT:Brenner Tumour Ovarian cancer