A CASE OF MALIGNANT BRENNER TUMOR DIAGNOSED BY POSTMORTEM EXAMINATIONS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 68; no. 11; pp. 2885 - 2889
• Main Authors: SHIMADA, Ken, TAKAHASHI, Tsuyoshi, ITABASHI, Koichi, FURUTA, Kazunori, WATANABE, Masahiko
• Format: Journal Article
• Language: Japanese; English
• Published: Japan Surgical Association 25.11.2007
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.68.2885

We report a case of malignant Brenner tumor arising in a 54-year-old woman. She was admitted to our hospital because of upper gastrointestinal tract obstruction. Radiographic examinations demonstrated a giant tumor widely spreading through the retroperitoneal space ranging between the pancreas head including the third portion of the duodenum, the right renal hilum, and tissues adjacent to the left ovary. Pancreaticoduodenectomy along with right nephrectomy were carried out. Histopathological examination gave a diagnosis of adenosquamous cell carcinoma originating from a lower portion of the common bile duct. When she died from the relapsing disease one year after surgery, however, postmortem examinations revealed that most organs in the abdominal cavity were involved in the tumor. The left ovary was moderately swollen and had been replaced by the tumor. Light microscopic examinations including immunohistochemical staining, as well as electron microscopic examination revealed that the tumor had characteristic features consistent with those of malignant Brenner tumor. Brenner tumor is known as a solid ovarian tumor, though the cell lineage remains unresolved. Malignant types of Brenner tumor are very rare, with one third showing extra-ovarian growth, and have an extremely poor prognosis. To date, no effective therapeutic modality has been established yet. Malignant Brenner tumor may thus pose a difficulty in the diagnosis and treatment to surgeons who encounter this tumor.