transitional cell tumour of the ovary

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 metastasesomental 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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