case_images: PMC7448206_01
case_images: MR findings for the borderline Brenner tumor in a 54-year-old woman. (a) The axial T2WI shows a unilocular cystic tumor in the pelvic cavity which was 9 cm in diameter with two solid components. The cystic content has the same signal intensity (SI) as water. The solid mass located at the anterior wall (white arrow) shows low SI similar to the SI of muscle. The papillary tumor on the left side of the solid mass (black arrow) shows an intermediate SI, slightly higher than the SI of muscle. (b) The axial T1WI shows the cystic content has slightly higher SI than water. The solid mass shows slightly lower SI than muscle. The papillary tumor on the left side of the solid mass shows low SI, similar to the SI for muscle. (c) Gadolinium-enhanced fat-saturated T1WI shows the solid mass is slightly enhanced and the papillary tumor is well enhanced. (d) Axial DWI (b = 0, 1000 s/mm2) shows a solid mass with a low SI and the papillary tumor with high SI.
case_images: CRIOG2020-8878649.001.jpg
case_images: PMC7448206_01_CRIOG2020-8878649.001.jpg
case_images: fig1
case_images: The solid mass located at the anterior wall showed a low SI similar to the SI of muscle in T2WIs and T1WIs, slightly enhanced on gadolinium-enhanced, fat-saturated T1WIs, and a low SI on DWI (Figure 1). The adjacent papillary tumor on the left side of the solid mass showed an intermediate SI, slightly higher SI than muscle in the T2WIs, well enhanced on contrast-enhanced fat-saturated T1WIs, and a high SI on DWI (Figure 1). The ADC value for the solid mass obtained from DWI (b = 0, 1000 s/mm2) was 0.51 x 10-3 mm2/s, whereas that for the papillary tumor was 1.10 x 10-3 mm2/s.
case_images: Coronal fused PET/CT image of the borderline Brenner tumor. The PET/CT shows a mild FDG uptake (SUVmax: 2.3) and calcification in the solid component (arrow), and moderate FDG uptake (SUVmax: 5.8) in the papillary tumor (curved arrow).
case_images: CRIOG2020-8878649.002.jpg
case_images: PMC7448206_01_CRIOG2020-8878649.002.jpg
case_images: fig2
case_images: Positron emission tomography/computed tomography (PET/CT) findings revealed mild FDG uptake (SUVmax: 2.3) and calcification in the solid mass, and moderate FDG uptake (SUVmax: 5.8) in the papillary tumor (Figure 2).
case_images: Pathology findings for the borderline Brenner tumor. (a) Macroscopically, the solid mass is hard and yellow-tan (arrow) in color and is accompanied by the papillary tumor (curved arrow). (b) A low-power microscopic examination of the solid mass with a low signal intensity in T2WIs demonstrates solid islands of epithelial cell nests in the fibrous stroma with hyalinization and calcification, indicating a benign Brenner tumor. (c) A low-power microscopic examination of the papillary tumor shows mucinous columnar epithelium and transitional epithelial cells without invasion. (d) A higher power image of the papillary tumor shows transitional epithelial cells that have longitudinal grooving with mild nuclear atypia, indicating a borderline Brenner tumor.
case_images: CRIOG2020-8878649.003.jpg
case_images: PMC7448206_01_CRIOG2020-8878649.003.jpg
case_images: fig3
case_images: Macroscopically, the cystic content was dark brownish, and a smooth solid mural mass accompanied by partial papillary projection was present (Figure 3(a)). Histological examination revealed that the solid component with low SI in the T2WIs showed solid islands of epithelial cell nests and longitudinal grooving in fibrous stroma with hyalinization and calcification, indicating a benign Brenner tumor (Figure 3(b)). On the other hand, the partial papillary projection showed mucinous columnar epithelium and transitional epithelial cells with mild nuclear atypia without invasion (Figure 3(c)-3(d)).