brenner tumour

Ovarian
torsion as a complication of Brenner tumour. US image. Left ovarian mass showing an internal hypoechoic area with tiny scattered hyperechoic foci exhibiting posterior acoustic shadowing, compatible with calcifications.
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Ovarian
torsion as a complication of Brenner tumour. US image. Left ovarian mass showing an internal hypoechoic area with calcifications (white arrow) surrounded by a homogeneous echogenic tissue with peripheral cysts.
www.eurorad.org • CC by-nc-sa-4.0
Ovarian
torsion as a complication of Brenner tumour. US image. Left mesovarium with a whirling appearance (arrow).
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Ovarian
torsion as a complication of Brenner tumour. Axial contrast-enhanced MSCT. Large, rounded and well-defined solid mass arising from the left ovary. Two distinct internal components may be seen. Of note, moderate ascites located at both abdominal flanks.
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Ovarian
torsion as a complication of Brenner tumour. Coronal maximum intensity projection of contrast-enhanced MSCT. Solid mass arising from the left ovary (white arrow) and left mesoovarium with whirling appearance (black arrow).
www.eurorad.org • CC by-nc-sa-4.0
Borderline
Brenner tumor of the ovary: a case report with immunohistochemical and molecular study. Contrast-enhanced CT scan showing a complex and heterogeneous pelvic mass with inner vegetations and septations in the anatomic site of the right adnexa (max diameter 17 cm), not dissociable from uterus and contiguous bowel (asterisk: pelvic mass; arrows: vegetations and septations; u: uterus).
ovarianresearch.biomedcentral.com • CC-by-4.0
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Brenner tumors are an uncommon surface epithelial tumor of the ovary. It was originally known as a transitional cell tumor due to its histological similarity to the urothelium. Brenner tumors account for ~3% of ovarian epithelial neoplasms. They can very rarely occur in other locations, including the testis.

Epidemiology

Most often found incidentally in women between their 5and 7decades of life.

Clinical presentation

They are most frequently found incidentally on pelvic examination or at laparotomy.

Pathology

Histological specimens often show transitional cells similar to neoplasms of the urothelium .

Associations

Brenner tumors are associated with another epithelial ovarian neoplasm of either the ipsilateral or contralateral ovary in ~30% of cases .

Location 

Brenner tumors can be bilateral in 6-7% of cases.

Radiographic features

Often manifesting as a multilocular cystic mass with a solid component or as a mostly solid mass.

Tumors are usually small (<2 cm). Even with the occasional large tumor (>10 cm), there is often a lack of local invasion, lymphadenopathy, ascites, or metastases (i.e. peritoneal metastases, omental caking), which help distinguish it from other malignant ovarian neoplasms.

Pelvic ultrasound

Brenner tumors are similar to other solid ovarian neoplasms, particularly fibromas-thecomas, and can also be confused with pedunculated leiomyomas.

They are mainly hypoechoic solid masses. Calcifications have been reported in 50% of Brenner tumors on ultrasound.

CT
  • calcifications have been reported in ~85% of Brenner tumors on CT
  • solid component may show mild to moderate enhancement post-contrast
MRI
  • due to its predominantly fibrous content, they appear hypointense on T2-weighted sequences

Treatment and prognosis

Most Brenner tumors are benign.

Differential diagnosis

General imaging differential considerations include:

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Assoziationen und Differentialdiagnosen zu Brenner-Tumor:
Neoplasien
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