Brenner tumors.

Area of Science:

• Gynecologic Oncology
• Pathology
• Radiology

Background:

• Brenner tumors are uncommon ovarian neoplasms characterized by transitional cells and dense fibrous stroma.
• They are typically small (<2 cm), incidentally found in asymptomatic women.
• Predominantly fibrous composition leads to low T2-weighted signal intensity on MRI, complicating differential diagnosis.

Purpose of the Study:

• To summarize the key imaging features of Brenner tumors.
• To highlight differential diagnostic considerations with other ovarian neoplasms like fibroma and thecoma.
• To discuss the potential for malignant and borderline variants of Brenner tumors.

Main Methods:

• Review of imaging characteristics of Brenner tumors, focusing on MRI findings (T2-weighted signal).
• Comparison of imaging features with ovarian fibroma and thecoma.
• Analysis of clinical presentation and associated findings, including estrogen excess and co-existing ovarian neoplasms.

Main Results:

• Brenner tumors exhibit low signal intensity on T2-weighted MRI due to their fibrous nature.
• Differentiation from fibroma/thecoma relies on secondary signs like estrogen excess symptoms or other ovarian neoplasms (present in up to 30%).
• While predominantly benign, malignant and borderline Brenner tumors have been reported.

Conclusions:

• Brenner tumors present a diagnostic challenge due to overlapping imaging features with benign fibroblastic neoplasms.
• Clinical context, including hormonal symptoms and associated lesions, is crucial for accurate diagnosis.
• Awareness of rare malignant/borderline forms is essential for comprehensive patient management.