卵巢交界性Brenner瘤4例临床病理分析

Ovarian borderline Brenner tumors: a clinicopathological study of 4 cases

目的探讨卵巢交界性Brenner瘤的临床病理特征、诊断和鉴别诊断。方法对4例卵巢交界性Brenner瘤进行组织病理学观察,1例辅以免疫组化分析,结合临床资料复习相关文献。结果患者年龄均>50岁,临床主要表现为腹痛和盆腔包块。肿块可为囊性、囊实性或实性,体积较大;镜下囊壁内衬上皮细胞,实性区的上皮巢大小不一、层次增多,细胞具有轻度异型性,与低级别尿路上皮癌相似。细胞巢排列紧密,可见分支,但基底界清,无间质浸润,可见良性成分,可出现明显黏液上皮化生,可合并黏液性囊腺瘤。结论交界性Brenner瘤是一种少见的卵巢上皮性肿瘤,预后良好,诊断主要根据组织病理和免疫组化标记,但须除外恶性。彻底切除肿瘤是治疗的主要手段。

Objective To investigate the clinicopathologic characteristics, diagnosis and differential diagnosis of ovarian borderline Brenner tumors. Methods The history records and the clinicopathoIogic data of 4 ovarian borderline Brenner tumors cases were evaluated retrospectively, and 1 case was studied with immunohistochemical staining. Related literatures were also reviewed. Results All Patients were more than 50 years old. The major clinical presentation included abdominal pain and masses in pelvic cavity. The masses were large and solid, cystic, solid and partly cystic lesion. Histologically, the borderline Brenner tumors showed uniform, larger and confluent nests and papillae of transitional cells with increasing cell layers and mild nuclear atypicality that resembled low grade urothelial papillary neoplasms. The outline of the epithelial nests was smooth, without stromal invasion. Benign Brenner tumors were always present. A mucinous epithelial component could be exhibited. Mucinous cystadenoma was associated with the borderline Brenner tumors. Conclusion Ovarian borderline Brenner tumor is a rare ovarian neoplasm with a good prognosis. Morphologic features as well as immunohistochemical marker may help in pathologic diagnosis. Sufficient section is needed to exclude malignant Brenner tumor. Completely surgical excision is the chief treatment.