Transitional Cell (Brenner) Tumor

Published on 31/05/2015 by admin

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Last modified 31/05/2015

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Chapter 143 Transitional Cell (Brenner) Tumor

INTRODUCTION

Description: A transitional cell (Brenner) tumor is an epithelial tumor that is made up of cells that resemble urothelium and Walthard’s cell nests, intermixed with the ovarian stroma. Most are benign.
Prevalence: One percent to 3% of ovarian tumors.
Predominant Age: 40 to 80, average 50.
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Unknown. Most are derived from ovarian surface epithelium that undergoes metaplasia to form the typical urothelial-like components.
Risk Factors: None known.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Asymptomatic (often an incidental finding after oophorectomy)
• Adnexal mass, generally solid, most smaller than 2 cm, bilateral in 6% (unilateral lesions are more common in the left ovary)
• Abdominal pain and swelling, with abnormal uterine bleeding (20%) if malignant disease (malignant masses are more likely to be large [10 to 30 cm] and contain cystic areas; when the ovary is palpably enlarged, the risk of malignancy is approximately 5%)

DIAGNOSTIC APPROACH

Differential Diagnosis

• Thecoma (fibroma)
• Stromal and germ cell tumors
• Endometrioma
• Benign cystic teratoma
• Serous or mucinous cystadenoma
• Metastatic tumors
• Pedunculated leiomyomata

Associated Conditions: Malignant tumors are associated with endometrial hyperplasia.

WORKUP AND EVALUATION

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