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A case of estrogen-producing Brenner tumor with a stromal component as a potential source for estrogen
Hisahiko Hiroi1, Yutaka Osuga, Yoshiko Tarumoto
1Department of Obstetrics and Gynecology, Hitachi General Hospital, Ibaraki, Japan.
Background:
Although Brenner tumors with endocrine activities have been reported, the source or mechanisms for hormone production is poorly known at present.
Case Report:
A 66-year-old Japanese woman presented with atypical vaginal bleeding. A left ovarian tumor was detected on ultrasonography and CT scanning. Her serum estradiol level was elevated (73.5 pg/ml). We performed total hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. The ovarian tumor was diagnosed as a benign Brenner tumor associated with simple hyperplasia of the endometrium. Postoperatively, the serum estradiol level decreased. Immunoreactivity of cytochrome P-450 aromatase was detected in stromal cells.
Conclusion:
Stromal contribution to the secretion of estrogen was shown in this case. Considering the known source of estrogen production being tumor cells in certain cases of Brenner tumor, there seem to be two types of estrogen-producing Brenner tumors depending on the source of estrogen, i.e. tumor cells or stromal cells.