Hwang Chung Su, Lee Chang Hun, Lee So Jeong, Kim Young Geum, Kim Ahrong, Park Do Youn, Kang Hyun Jeong, Shin Dong Hoon
Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Department of Pathology and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
World J Surg Oncol. 2017 Mar 28;15(1):72. doi: 10.1186/s12957-017-1135-2.
Brenner tumors almost always develop in the ovary. Exceptionally, extraovarian Brenner tumors have been reported in the lower abdomen or pelvic organs. Here, we introduce a peculiar case of an extraovarian Brenner tumor arising in the omentum.
A 43-year-old woman presented with a palpable abdominal mass. Computed tomography (CT) scan revealed a 9.0-cm solid mass in the omentum. The tumor was not associated with pelvic structures, including the ovaries. It was excised under the clinical impression of an extragastrointestinal stromal tumor or neurogenic tumor. Grossly, the mass was a well-circumscribed solid tumor, with yellow-tan cut surface and minute cystic spaces. Microscopically, the tumor showed well-defined epithelial nests with variable cystic changes embedded in an abundant fibrous stroma. The cells within the nests were reminiscent of benign urothelial cells in that they had oval, frequently grooved nuclei. The epithelial cells focally showed a gradual transition into the surrounding stromal cells with short spindled features. The urothelium-like cells were positive for pancytokeratin, WT-1, p63, CK7, uroplakin-III, and GATA-3 but were negative for CD34, CD10, CK20, c-KIT, DOG-1, PAX-8, and calretinin. Morphological and immunohistochemical features of the tumor were the same as an ovarian Brenner tumor, and so it was diagnosed as an extraovarian Brenner tumor.
Although the location of the tumor was very unusual, we could diagnose the tumor as an extraovarian Brenner tumor on the basis of the histologic and immunohistochemical findings. This is the first case of extraovarian Brenner tumor arising in the omentum near the stomach ever reported in the English literature.
勃勒纳瘤几乎总是发生于卵巢。极个别情况下,曾有报道称在下腹部或盆腔器官发现卵巢外勃勒纳瘤。在此,我们介绍一例发生于大网膜的特殊卵巢外勃勒纳瘤病例。
一名43岁女性,腹部可触及肿块。计算机断层扫描(CT)显示大网膜有一个9.0厘米的实性肿块。该肿瘤与包括卵巢在内的盆腔结构无关。在临床诊断为胃肠道外间质瘤或神经源性肿瘤的情况下将其切除。大体上,肿块是一个边界清楚的实性肿瘤,切面呈黄棕色,有微小囊腔。显微镜下,肿瘤表现为界限清楚的上皮巢,有不同程度的囊性改变,包埋于丰富的纤维性间质中。巢内细胞类似良性尿路上皮细胞,核呈椭圆形,常有沟纹。上皮细胞局部显示逐渐过渡为周围具有短梭形特征的间质细胞。尿路上皮样细胞全细胞角蛋白、WT-1、p63、CK7、uroplakin-III和GATA-3呈阳性,但CD34、CD10、CK20、c-KIT、DOG-1、PAX-8和钙视网膜蛋白呈阴性。肿瘤的形态学和免疫组化特征与卵巢勃勒纳瘤相同,因此诊断为卵巢外勃勒纳瘤。
尽管肿瘤位置非常不寻常,但根据组织学和免疫组化结果,我们能够将该肿瘤诊断为卵巢外勃勒纳瘤。这是英文文献中首次报道的发生于胃附近大网膜的卵巢外勃勒纳瘤病例。