Department of Gastroenterology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, 230601, China.
Center of Gut Microbiota, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Ir J Med Sci. 2023 Oct;192(5):2071-2075. doi: 10.1007/s11845-022-03203-7. Epub 2022 Nov 21.
Ovarian Brenner tumor with abnormally increased serum carbohydrate antigen 19-9 (CA19-9) level is extremely rare. A 70-year-old woman with abnormally elevated serum CA199 (1289 U/ml) found in routine physical examination. Pelvic CT and MRI scan revealed a large mass with large patches of calcification in the right adnexal area, and the patient achieved total hysterectomy and bilateral adnexectomy. Grossly, the right ovary had a solid enlargement of about 7.0 cm × 6.0 cm × 5.0 cm with irregular nodules and smooth surface and the cut surface of the mass showed that the tumor is cystic and solid. Microscopically, the tumor showed a background of fibrous tissue hyperplasia with nested and adenoid cell clusters with uniform cell size and clear boundaries. The cells were translucent with eosinophilic cytoplasm and calcification. Immunohistochemical staining showed CK7, CA125, and P63 presented diffusely strongly positive staining, while negativity for CK20, GATA3, AR, P53, and CgA. Ki-67 showed weak positive staining, about 1%. The serum CA199 level decreased significantly on the 5th day after surgery. Postoperative pathology and immunohistochemistry confirmed borderline Brenner tumor. This is the first to report a case of borderline Brenner tumor with an abnormally high serum level of CA199 before surgery. In clinical practice, the possibility of ovarian Brenner tumor should be considered when abnormal elevation of serum CA199 level cannot be reasonably explained.
卵巢 Brenner 肿瘤伴血清糖链抗原 19-9（CA19-9）水平异常升高极为罕见。一位 70 岁女性在常规体检时发现血清 CA199 异常升高（1289 U/ml）。盆腔 CT 和 MRI 扫描显示右侧附件区有一个大肿块，有大片钙化斑，患者行全子宫切除术和双侧附件切除术。大体检查发现右侧卵巢实性增大，约 7.0×6.0×5.0cm，表面有不规则结节，切面见肿瘤囊性和实性。镜下，肿瘤背景为纤维组织增生，有巢状和腺样细胞簇，细胞大小均匀，边界清楚。细胞胞质透亮，嗜酸性，伴有钙化。免疫组化染色显示 CK7、CA125 和 P63 弥漫强阳性表达，而 CK20、GATA3、AR、P53 和 CgA 阴性。Ki-67 弱阳性表达，约 1%。术后第 5 天，血清 CA199 水平显著下降。术后病理及免疫组化证实为交界性 Brenner 肿瘤。这是首例术前血清 CA199 水平异常升高的交界性 Brenner 肿瘤报道。在临床实践中，当不能合理解释血清 CA199 水平异常升高时，应考虑卵巢 Brenner 肿瘤的可能性。
