Dural metastases as a presentation of a Brenner tumor.

We present a 56-year-old woman who came to our institution with a 6-month history of intracranial hypertension. Imaging studies showed diffuse dural enhancement, multiple lytic bone lesions and a tumor in the left ovary. A meningeal biopsy was performed; however, during this procedure the patient developed profuse dural hemorrhage and middle cerebral artery territory infarction and died a few hours later. The autopsy revealed a disseminated Brenner tumor that was infiltrating the intracranial dura mater. At this site neovascularization, vascular infiltration by malignant cells and a desmoplastic reaction were all observed, perhaps rendering the patient more susceptible to a dural hemorrhage during the biopsy. To our knowledge, this is the first report of a Brenner tumor presenting as dural metastases.

Metastatic Brenner tumor--a case report.

In our report we present a case of metastatic Brenner tumor of the right ovary in a 74-year-old woman. The diagnosis was based on microscopic examination of surgical specimen and a comparison of the immunohistochemical profile of the primary and metastatic tumors. Additionally, we proved urothelial differentiation of the proliferating Brenner tumor, which is in accordance with the literature.

Malignant Brenner tumors of the ovary and tumor markers: case reports.

We investigated the tumor marker for malignant Brenner tumors, which had not been established because of the rarity and variable histological criteria. Representative areas of two cases of malignant Brenner tumor were investigated by means of the peroxidase-antiperoxidase method using monoclonal antibody to CA125 and CA72-4 antigen and the streptavidin-biotin immunoperoxidase complex method using monoclonal antibody to SCC antigen. Based on clinical course and immunohistochemical studies, serum CA125 and CA72-4 for Case 1 and SCC and CA72-4 for Case 2 were appropriate tumor markers for the establishment of the extent of tumor burden before treatment and to monitor the response to therapy. The discrepancy of the tumor markers of the two present cases is considered to be a reflection of the difference in the malignant component of these cases. However, serum CA72-4 was an appropriate tumor marker for both malignant Brenner tumors.

Fine needle aspiration cytology of a subcutaneous metastasis of a malignant Brenner tumor of the ovary. A case report.

The fine needle aspiration cytologic findings of a subcutaneous metastasis from a malignant Brenner tumor of the ovary are described. Polygonal cells in clusters and single cells with fine cytoplasmic elongations, moderately pleomorphic nuclei having granular chromatin and multinucleate cells, occasional but prominent grooving of nuclei and many mitotic figures were the salient cytologic features. The cytohistologic correlation was good. The rare metastatic site of this unusual ovarian neoplasm makes this an interesting case and the first of its kind to the best of our knowledge.

Malignant Brenner tumor: a case of aggressive clinical course and cutaneous metastases.

Malignant Brenner tumor is a very rare ovarian tumor of which the definition of this entity and its biologic behavior remain controversial to this day. In this case report a 30-year-old patient with malignant Brenner tumor was presented with an aggressive clinical course and cutaneous metastases. The disease progressed from apparently unilateral ovarian involvement to intraabdominal, lung and cutaneous metastases. She expired within two months of diagnosis of disease. The histopathology of the ovarian tumor and the metastatic skin lesion are illustrated. In the authors' opinion this case should be categorized as a transitional cell carcinoma of the ovary.

Carcinoembryonic antigen in primary and metastatic ovarian tumors.

The immunoperoxidase method and an absorbed monospecific commercial rabbit anti-CEA antiserum were used to detect CEA in 105 primary ovarian tumors and 12 metastatic ovarian adenocarcinomas of intestinal origin. Primary ovarian tumors showed CEA in foci of squamous differentiation in 9 out of 10 cases of endometrioid carcinomas and focally in areas of intestinal differentiation in 21 out of 28 mucinous tumors as well as 4 out of 5 Brenner tumors. All of the serous tumors, clear cell carcinomas, and undifferentiated carcinomas as well as 19 of the 22 mucinous tumors without intestinal differentiation lacked CEA. All metastatic ovarian adenocarcinomas showed characteristic diffuse staining of CEA. Differences in CEA staining were found to be useful for histological differentiation between primary ovarian cancers and metastatic ovarian adenocarcinomas of intestinal origin. Furthermore, these data might be helpful in the selection of patients for serial CEA evaluation.

Bilateral malignant Brenner tumor: report of a case with ultrastructural study.

An unusual case of bilateral malignant Brenner tumor with liver and omental metastases is reported. The tumor was histologically a transitional cell carcinoma comparable to a grade III bladder carcinoma. A benign component was not identified, but there were a few nests of malignant epithelial cells distributed in a dense stroma, a pattern identical to that seen in a benign Brenner tumor. Whether this represents malignant change in a previously benign focus or a well differentiated part of a de novo carcinoma is unclear. Nevertheless it is suggested that the current histologic criteria for malignant Brenner tumor be modified to exclude the requirement of an intimately associated benign Brenner tumor. Ultrastructurally the malignant Brenner tumor has many features of the benign Brenner tumor. Some features, notably the basal lamina, micropinocytotic vesicles, nd intracytoplasmic microfibrils, are herein described for the first time in a malignant Brenner tumor.