Brenner tumor

Last revised by Yuranga Weerakkody on 10 Apr 2022

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.

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 covered by fibrous stroma, similar to neoplasms of the urothelium 8,9.

Brenner tumors are associated with another epithelial ovarian neoplasm of either the ipsilateral or contralateral ovary in ~30% of cases 6.  

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

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.

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.

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

Most Brenner tumors are benign.

General imaging differential considerations include:

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