Brenner tumours are an uncommon subtype of the surface epithelial-stromal tumour group of ovarian neoplasms. The majority are

benign Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...

, but some can be

malignant Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...

. They are most frequently found incidentally on

pelvic examination A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, ...

or at

laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ...

. Brenner tumours very rarely can occur in other locations, including the

testes A testicle or testis ( testes) is the gonad in all male bilaterians, including humans, and is homologous to the ovary in females. Its primary functions are the production of sperm and the secretion of androgens, primarily testosterone. The ...

Presentation

On gross

pathological Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...

examination, they are solid, sharply circumscribed and pale yellow-tan in colour. 90% are unilateral (arising in one ovary, the other is unaffected). The tumours can vary in size from less than to . Borderline and malignant Brenner tumours are possible but each are rare.

Diagnosis

Brenner tumor with annotated coffee bean nuclei

Histologically Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...

, there are nests of

transitional epithelial Transitional epithelium is a type of stratified epithelium. Transitional epithelium is a type of tissue that changes shape in response to stretching (stretchable epithelium). The transitional epithelium usually appears cuboidal when relaxed and ...

( urothelial) cells with longitudinal nuclear grooves ( coffee bean nuclei) lying in abundant fibrous stroma. The coffee bean nuclei are the nuclear grooves exceptionally pathognomonic to the sex cord stromal tumour, the ovarian granulosa cell tumour, with the fluid-filled spaces

Call–Exner bodies Call–Exner bodies, giving a follicle-like appearance, are small eosinophilic fluid-filled punched out spaces between granulosa cells. The granulosa cells are usually arranged haphazardly around the space. They are pathognomonic for granulosa c ...

between the granulosa cells.

Similar conditions

Transitional cell carcinoma is an even rarer entity, in which neoplastic transitional epithelial cells similar to transitional cell carcinoma of the bladder are seen in the ovary, without the characteristic stromal/epithelial pattern of a Brenner tumour. Histologically, Leydig cell tumours of the testes and ovarian stromal Leydig cell tumours (ovarian hyperandrogenism and virilization) both have characteristic

Reinke crystals Reinke crystals are rod-like cytoplasmic inclusions which can be found in Leydig cells of the testes. Occurring only in adult humans and wild bush rats, their function is unknown. Ovarian stromal tumors having a predominant pattern of fibroma or t ...

. The same crystals were also noted under high-power view in Brenner tumours.

Eponym

It is named for Fritz Brenner (1877–1969), a German surgeon who characterized it in 1907. The term "Brenner tumour" was first used by

Robert Meyer Robert Meyer (born October 2, 1945 in Oslo, Norway) is a Norwegian art photographer, professor, photo historian, collector, writer and publicist. He is the son of journalist Robert Castberg Meyer and homemaker Edel Nielsen; and brother of the in ...

, in 1932.

Additional images

File:Walthard cell rest - very high mag.jpg,

Micrograph A micrograph is an image, captured photographically or digitally, taken through a microscope or similar device to show a magnify, magnified image of an object. This is opposed to a macrograph or photomacrograph, an image which is also taken ...

of a

Walthard cell nest Walthard cell rests, sometimes called Walthard cell nests, are a benign cluster of epithelial cells most commonly found in the connective tissue of the fallopian tubes, but also seen in the mesovarium, mesosalpinx and ovarian hilus. Appearance T ...

, the entity Brenner tumours are thought to arise from.

H&E stain Hematoxylin and eosin stain ( or haematoxylin and eosin stain or hematoxylin–eosin stain; often abbreviated as H&E stain or HE stain) is one of the principal tissue stains used in histology. It is the most widely used stain in medical diag ...

References

External links

*
Histology
at

University of Utah The University of Utah (the U, U of U, or simply Utah) is a public university, public research university in Salt Lake City, Utah, United States. It was established in 1850 as the University of Deseret (Book of Mormon), Deseret by the General A ...

{{DEFAULTSORT:Brenner Tumour Ovarian cancer