A borderline ovarian Brenner tumor mimicks uterine fibroids

Abstract

Brenner tumors are uncommon tumors that are a part of the surface epithelialestromal tumor group of ovarian neoplasms. Most of these tumors are benign. However, they can be malignant. They are most frequently detected as incidental findings on pelvic examination or at laparotomy. Besides, they can occur in other locations very rarely, including the testes. We report on this rare, gynecological, borderline adnexal tumor because it mimicks the common, benign uterine fibroids we see in our daily practice. A 47-year-old woman had a 3-year history of profuse menstrual bleeding. The gynecological ultrasound showed an enlarged uterus with a right-wall tumor mass measuring about 50 mm in size. We suggested conservative treatment and regular ultrasound follow-up. Unfortunately, the tumor was accompanied by several microcalcifications and grew to 80 mm within 6 months (Fig. 1), when surgical intervention was indicated. During the operation, the uterus appeared to be in normal size, but an enlarged right ovarian solid tumor, about 8 cm in size, was adhered to the uterus and the peritoneum. This solid tumor’s surface was smooth, and the content was yellowish in color (Fig. 2). Unfortunately, the frozen section showed malignant cells of fibrous composition in the tumor, and the metastatic tumor was first impressed. Complete staging surgery, including a total hysterectomy, a bilateral salpingo-oophorectomy, an infracolic omentectomy; a pelvic and para-aortic lymph node sampling; and an appendectomy were done. The gross tumor (about 8 cm in size) was in the right ovary, with the outer surface lobulated, intact, and without adhesions. The sectioned surface of the main tumor contained 100% solid components that were yellow-white in color with a firm consistency. The contralateral ovary was mildly enlarged with focal, whitish nodule formation (18 mm). The other specimens were unremarkable. The microscopic findings indicated a right ovarian tumor exhibiting irregular epithelioid tumor nests infiltrating a dense