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Difference between revisions of "Brenner tumour"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Brenner tumour high mag.jpg | | Image = Brenner tumour high mag cropped.jpg | ||
| Width = | | Width = | ||
| Caption = Brenner tumour. [[H&E stain]]. | | Caption = Brenner tumour. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = nests | | Micro = nests cells that have a "[[coffee bean nucleus]]" (nucleus = elliptical shape, nuclear groove along long axis), distinct nucleoli, moderate-to-abundant gray/pale cytoplasm, dense fibrous stroma around nests | ||
| Subtypes = | | Subtypes = benign (most common), borderline, malignant | ||
| LMDDx = [[granulosa cell tumour]], [[ovarian fibroma]], [[thecoma]] | | LMDDx = [[granulosa cell tumour]], [[ovarian fibroma]], [[thecoma]], [[Walthard cell rest]] | ||
| Stains = | | Stains = | ||
| IHC = AR +ve, calretinin -ve | | IHC = AR +ve, calretinin -ve | ||
| Line 13: | Line 13: | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = classically solid (may be cystic), usu. well-circumscribed, light yellow colour | ||
| Grossing = | | Grossing = | ||
| Site = [[ovary]] (see ''[[ovarian tumours]]''), [[fallopian tube]] | | Site = [[ovary]] (see ''[[ovarian tumours]]''), [[fallopian tube]] | ||
| Line 33: | Line 33: | ||
==General== | ==General== | ||
*Considered to be rare | *Considered to be rare<ref>{{Cite journal | last1 = Bilici | first1 = A. | last2 = Inanc | first2 = M. | last3 = Ulas | first3 = A. | last4 = Akman | first4 = T. | last5 = Seker | first5 = M. | last6 = Babacan | first6 = NA. | last7 = Inal | first7 = A. | last8 = Bal | first8 = O. | last9 = Koral | first9 = L. | title = Clinical and pathologic features of patients with rare ovarian tumors: multi-center review of 167 patients by the anatolian society of medical oncology. | journal = Asian Pac J Cancer Prev | volume = 14 | issue = 11 | pages = 6493-9 | month = | year = 2013 | doi = | PMID = 24377556 }}</ref> - 1-2% of ovarian neoplasms.<ref>{{Cite journal | last1 = Arnogiannaki | first1 = N. | last2 = Grigoriadis | first2 = C. | last3 = Zygouris | first3 = D. | last4 = Terzakis | first4 = E. | last5 = Sebastiadou | first5 = M. | last6 = Tserkezoglou | first6 = A. | title = Proliferative Brenner tumor of the ovary. clinicopathological study of two cases and review of the literature. | journal = Eur J Gynaecol Oncol | volume = 32 | issue = 5 | pages = 576-8 | month = | year = 2011 | doi = | PMID = 22053680 }}</ref> | ||
*Traditionally, BT has been grouped within the ''transistional cell tumours'' category in the surface epithelial group of ovarian tumours. | *Traditionally, BT has been grouped within the ''transistional cell tumours'' category in the surface epithelial group of ovarian tumours. | ||
**Recently, [[transistional cell carcinoma of the ovary]] has been related to [[serous carcinoma]]; TCC of the ovary is probably distinct from the malignant Brenner tumour.<ref>{{Cite journal | last1 = Ali | first1 = RH. | last2 = Seidman | first2 = JD. | last3 = Luk | first3 = M. | last4 = Kalloger | first4 = S. | last5 = Gilks | first5 = CB. | title = Transitional cell carcinoma of the ovary is related to high-grade serous carcinoma and is distinct from malignant brenner tumor. | journal = Int J Gynecol Pathol | volume = 31 | issue = 6 | pages = 499-506 | month = Nov | year = 2012 | doi = 10.1097/PGP.0b013e31824d7445 | PMID = 23018212 }}</ref> | **Recently, [[transistional cell carcinoma of the ovary]] has been related to [[serous carcinoma]]; TCC of the ovary is probably distinct from the malignant Brenner tumour.<ref>{{Cite journal | last1 = Ali | first1 = RH. | last2 = Seidman | first2 = JD. | last3 = Luk | first3 = M. | last4 = Kalloger | first4 = S. | last5 = Gilks | first5 = CB. | title = Transitional cell carcinoma of the ovary is related to high-grade serous carcinoma and is distinct from malignant brenner tumor. | journal = Int J Gynecol Pathol | volume = 31 | issue = 6 | pages = 499-506 | month = Nov | year = 2012 | doi = 10.1097/PGP.0b013e31824d7445 | PMID = 23018212 }}</ref> | ||
*May arise from the [[fallopian tube]].<ref name=pmid24012099>{{Cite journal | last1 = Kuhn | first1 = E. | last2 = Ayhan | first2 = A. | last3 = Shih | first3 = IeM. | last4 = Seidman | first4 = JD. | last5 = Kurman | first5 = RJ. | title = Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. | journal = Eur J Cancer | volume = 49 | issue = 18 | pages = 3839-49 | month = Dec | year = 2013 | doi = 10.1016/j.ejca.2013.08.011 | PMID = 24012099 }}</ref> | *May arise from the [[fallopian tube]].<ref name=pmid24012099>{{Cite journal | last1 = Kuhn | first1 = E. | last2 = Ayhan | first2 = A. | last3 = Shih | first3 = IeM. | last4 = Seidman | first4 = JD. | last5 = Kurman | first5 = RJ. | title = Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. | journal = Eur J Cancer | volume = 49 | issue = 18 | pages = 3839-49 | month = Dec | year = 2013 | doi = 10.1016/j.ejca.2013.08.011 | PMID = 24012099 }}</ref> | ||
*Can be seen in the [[testis]].<ref name=pmid15502808>{{cite journal |author=Amin MB |title=Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors |journal=Mod. Pathol. |volume=18 Suppl 2 |issue= |pages=S131–45 |year=2005 |month=February |pmid=15502808 |doi=10.1038/modpathol.3800314 |url=}}</ref> | |||
===Epidemiology=== | ===Epidemiology=== | ||
*Mostly benign clinical course. | *Mostly benign clinical course - 99% of Brenner tumours benign.<ref name=Ref_GP437>{{Ref GP|437}}</ref> | ||
*Thought to arise from [[Walthard cell rest]]. | *Thought to arise from [[Walthard cell rest]]. | ||
*Frequently an incidental finding, i.e. oophorectomy was done for another reason. | *Frequently an incidental finding, i.e. oophorectomy was done for another reason. | ||
| Line 66: | Line 67: | ||
*Stromal component may be predominant. | *Stromal component may be predominant. | ||
DDx: | DDx:<ref name=Ref_GP437>{{Ref GP|437}}</ref> | ||
*[[Ovarian fibroma]]. | *Benign: | ||
*[[ | **Endometrioid adenofibroma. | ||
**[[Ovarian fibroma]]. | |||
*Borderline: | |||
**Benign Brenner tumour. | |||
**Malignant Brenner tumour. | |||
**Metastatic papillary urothelial carcinoma. | |||
*Malignant: | |||
**Undifferentiated carcinoma - no Brenner tumour component. | |||
**Granulosa cell tumour. | |||
**Serous carcinoma. | |||
**Metastatic urothelial carcinoma. | |||
*[[Walthard cell rest]] - typically one nest of cells, lacks the surrounding fibromatous stroma. | |||
===Images=== | ===Images=== | ||
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==IHC== | ==IHC== | ||
Features:<ref>{{Cite journal | last1 = Kuhn | first1 = E. | last2 = Ayhan | first2 = A. | last3 = Shih | first3 = IeM. | last4 = Seidman | first4 = JD. | last5 = Kurman | first5 = RJ. | title = Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. | journal = Eur J Cancer | volume = 49 | issue = 18 | pages = 3839-49 | month = Dec | year = 2013 | doi = 10.1016/j.ejca.2013.08.011 | PMID = 24012099 }}</ref> | Features:<ref name=pmid24012099>{{Cite journal | last1 = Kuhn | first1 = E. | last2 = Ayhan | first2 = A. | last3 = Shih | first3 = IeM. | last4 = Seidman | first4 = JD. | last5 = Kurman | first5 = RJ. | title = Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. | journal = Eur J Cancer | volume = 49 | issue = 18 | pages = 3839-49 | month = Dec | year = 2013 | doi = 10.1016/j.ejca.2013.08.011 | PMID = 24012099 }}</ref> | ||
*AR +ve. | *[[Androgen receptor|AR]] +ve. | ||
*Calretinin -ve. | *Calretinin -ve. | ||
**Surrounding stroma +ve. | **Surrounding stroma +ve. | ||
*Inhibin +ve.<ref name=pmid24012099>{{Cite journal | last1 = Kuhn | first1 = E. | last2 = Ayhan | first2 = A. | last3 = Shih | first3 = IeM. | last4 = Seidman | first4 = JD. | last5 = Kurman | first5 = RJ. | title = Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium. | journal = Eur J Cancer | volume = 49 | issue = 18 | pages = 3839-49 | month = Dec | year = 2013 | doi = 10.1016/j.ejca.2013.08.011 | PMID = 24012099 }}</ref> | |||
==See also== | ==See also== | ||
*[[Ovarian tumours]]. | *[[Ovarian tumours]]. | ||
*[[Walthard cell rest]]. | |||
*[[Testis]]. | |||
==References== | ==References== | ||