Brenner tumours are an uncommon surface epithelial tumour of the ovary. It was originally known as a transitional cell tumour due to its histological similarity to the urothelium. Brenner tumours account for ~3% of ovarian epithelial neoplasms. They can very rarely can occur in other locations, including the testis.
Most often found incidentally in women between their 5th and 7th decades of life.
They are most frequently found incidentally on pelvic examination or at laparotomy.
Histological specimens often show transitional cells similar to neoplasms of the urothelium 8.
Brenner tumours are associated with another epithelial ovarian neoplasm of either the ipsilateral or contralateral ovary in ~ 30% of cases 6.
Brenner tumours can be bilateral in 6-7% of cases.
Often manifest as a multilocular cystic mass with a solid component or as a mostly solid mass.
Tumours are usually small (<2 cm). Even with the occasional large tumour (>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.
Brenner tumours 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 tumours on ultrasound.
- calcifications have been reported in ~ 85% of Brenner tumours on CT
- solid component may show mild to moderate enhancement post contrast
- due to its predominantly fibrous content content they appear hypointense on T2 weighted sequences
Treatment and prognosis
Most Brenner tumours are benign.
General imaging differential considerations include
- 1. Green GE, Mortele KJ, Glickman JN et-al. Brenner tumors of the ovary: sonographic and computed tomographic imaging features. J Ultrasound Med. 2006;25 (10): 1245-51. J Ultrasound Med (full text) - Pubmed citation
- 2. Caccamo D, Socias M, Truchet C. Malignant Brenner tumor of the testis and epididymis. Arch. Pathol. Lab. Med. 1991;115 (5): 524-7. - Pubmed citation
- 3. Athey PA, Siegel MF. Sonographic features of Brenner tumor of the ovary. J Ultrasound Med. 1987;6 (7): 367-72. J Ultrasound Med (abstract) - Pubmed citation
- 4. Moon WJ, Koh BH, Kim SK et-al. Brenner tumor of the ovary: CT and MR findings. J Comput Assist Tomogr. 24 (1): 72-6. J Comput Assist Tomogr (link) - Pubmed citation
- 5. Kim KA, Park CM, Lee JH et-al. Benign ovarian tumors with solid and cystic components that mimic malignancy. AJR Am J Roentgenol. 2004;182 (5): 1259-65. AJR Am J Roentgenol (full text) - Pubmed citation
- 6. Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999;212 (1): 5-18. Radiology (full text) - Pubmed citation
- 7. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- 8. Cuatrecasas M, Catasus L, Palacios J et-al. Transitional cell tumors of the ovary: a comparative clinicopathologic, immunohistochemical, and molecular genetic analysis of Brenner tumors and transitional cell carcinomas. Am. J. Surg. Pathol. 2009;33 (4): 556-67. doi:10.1097/PAS.0b013e318188b84c - Pubmed citation