Brenner's tumor is a rather rare pathology. This neoplasm is usually detected during a surgical intervention in the treatment of any gynecological disease. The main danger of the tumor is its asymptomatic development, which leads to the fact that the problem is detected only at a late stage, when surgical intervention may already be ineffective.
What is a neoplasm?
Brenner's tumor has another name - fibroepithelioma. Experts classify it as a clear cell cystic formation, they are mostly benign.
Pathology develops most often after 40 years, but can be found at any age, and even in a child. In structure, the tumor is similar to fibroma, it is made up of connective tissues with single epithelial cells. A characteristic feature that distinguishes this type of tumor is the presence of epithelial nests. They are similar to epidermal cells, but are usually the transitional epithelium of the urinary tract.
The size of the tumor varies from a few millimeters to tens of centimeters. It usually has the shape of a ball. The capsule is absent, the tissues in the node are dense, white or grayish in color. Inside, there may be multiple small cysts with mucous contents.
Many women are interested in the question: "Is Brenner's tumor a cancer or not?" Doctors say that most often the process is benign in nature, the neoplasm is malignant in very rare cases. The risk increases with a significant size of the tumor (more than fifteen centimeters). Often, in the presence of pathology, the presence of other neoplasms is also noted.
Classification
Depending on the form of the neoplasm, treatment is also selected. There are three types of tumors of this kind:
- Benign (most common). They are clearly demarcated from neighboring tissues, have a smooth or lobulated surface.
- Borderline. They have some signs of malignancy, but the process usually proceeds favorably. They consist of single-chamber or multi-chamber cysts, do not germinate into neighboring structures, do not metastasize.
- Malignant. Such neoplasms in the ovary are the most dangerous, capable of destroying neighboring structures, their growth is uncontrollable.
Borderline and malignant Brenner tumors, in turn, are distinguished by stages and prevalence.
Causes of disease development
Specific factors that can lead to the development of the disease,not detected. However, the pathological process can be triggered as a result of:
- chronic infections occurring in the body;
- inflammation of the genital area;
- hormonal disorders;
- long-term hormone therapy;
- early onset of puberty;
- stress and nervous shocks;
- chronic liver disease;
- menstrual irregularities;
- viral diseases suffered by a future mother in the process of bearing a baby;
- presence of other tumor formations;
- long-term conservative treatment of fibroids without a positive result;
- frequent acute respiratory viral infections in childhood and adolescence, which are difficult;
But the exact causes of Brenner's tumor have not been established, the pathology is poorly understood, various factors can provoke its development.
Symptoms of the development of the pathological process
The neoplasm can increase in size gradually, or it can grow rapidly.
With a small size, nothing bothers a woman, her he alth does not suffer. The problem is often discovered incidentally during surgery for another reason or during instrumental studies.
Education of a large size is already making itself felt with some signs. Sometimes they are similar to the symptoms of inflammation of the ovaries in women and are accompanied by pain on the affected side. She can be dull, aching. A woman, for no apparent reason, mayenlarge belly. Neighboring organs, squeezed by the tumor, suffer. The patient may feel discomfort in the abdominal cavity, suffer from bloating, belching, nausea, vomiting, constipation. If the urinary tract is compressed, problems arise when urinating. If the formation is hormonally active, then the pathology may be accompanied by:
- intermenstrual bleeding;
- profuse long periods;
- disturbed menstruation.
Women who have entered the postmenopausal period may resume bleeding from the genital tract, reminiscent of menstruation, and increase libido. These symptoms should prompt an immediate visit to the doctor.
Diagnostic measures
Diagnosis of the disease is fraught with some difficulties, since the initial stage of the development of pathology is easy to miss due to the small size of the tumor and its slow growth. At this stage, the woman does not feel discomfort, it appears when the tumor grows to a significant size.
Brenner's tumor is often confused with other gynecological pathologies, sometimes mistaking its manifestations for symptoms of ovarian inflammation in women and other conditions. Therefore, to make a diagnosis, a comprehensive examination is necessary, including:
- Inspection in mirrors and palpation. In the process of a two-handed examination, the doctor discovers a neoplasm in the ovarian region, which is very dense and smooth, not soldered to other organs and tissues. The patient may experience discomfort on palpation.
- Urine and blood tests, hormonal testing. Allows you to assess the general condition of the body.
- Blood test for oncomarker CA-125. This allows you to distinguish between a benign tumor and a malignant one, but the results of the study are sometimes questionable.
- Smear on microflora. Helps to identify the presence of an inflammatory process.
- PAP test. Allows to exclude other tumor processes.
- Ultrasound. The method allows you to visualize the tumor, determine its location, size and shape.
- CT and MRI. Brenner's tumor cannot always be fully examined with the help of ultrasound, it sometimes does not give a complete picture of the disease. Data obtained using computed tomography or magnetic resonance imaging are more accurate and detailed. MRI can detect small tumors that were not seen during the ultrasound.
- Laparoscopy. They use the technique in order to assess the state of other organs, the work of which could be disrupted by the pathological process.
- Lymphography. Allows you to assess the condition of the lymph nodes that are next to the neoplasm.
- Biopsy. During the study, a tissue sample is taken, which is carefully examined under a microscope. This method evaluates the nature of the tumor and its structure.
Methods of treating the disease
Surgical treatment of Brenner's tumor. The type of intervention is chosen taking into account the size of the neoplasm, agewomen, as well as the state of her body. Very often, the affected ovary is excised along with the tumor.
How is the operation performed?
The operation can be performed by laparotomy (direct access through an incision in the abdomen) or laparoscopy (through three small punctures in the abdominal cavity). The latter method is used if the tumor is small. If the neoplasm is of impressive size, the patient suffers from chronic inflammatory processes in the small pelvis with the formation of adhesions, then a laparotomy is performed. Excised tissues are sent for histology to determine their malignancy.
Signs of a benign tumor are:
- collagen fibers that make up the stroma;
- lack of lipids in the underlying tissue;
- presence of epithelial nests;
- layered arrangement of cells in epithelial nests;
- mucinous contents of microcysts.
Malignancy can be judged by numerous mitoses, the presence of atypical cells.
Recovery after intervention
If necessary, chemotherapy is prescribed after the intervention. It is also recommended to carry out other activities that will help support the body and restore its functions.
If the problem is unilateral, then after surgical therapy, the reproductive function does not suffer. After the operation, the balance of hormones returns to normal if the work of the second ovary is not disturbed. If the intervention was carried out on both sides, then stabilize the hormonal backgroundwomen of reproductive age will benefit from HRT.
Consequences and complications
The pathological process can be complicated by torsion of the tumor stem, which will lead to tissue necrosis. This condition requires immediate surgical intervention. Large tumors disrupt the functioning of vital organs, resulting in severe cardiovascular and respiratory failure.
Lack of timely treatment leads to the progression of the disease and even to malignancy of the tumor - this is the most formidable complication. The late stage can be fatal, since even the operation in this case may be ineffective, especially with borderline neoplasms.
Forecast
If the neoplasm is benign or borderline, then the prognosis is favorable. But borderline tumors can recur and become malignant.
If the tumor is malignant, 88% of patients live after 5 years of therapy. As the lesion spreads, the prognosis worsens.
Prevention of disease progression
The exact causes of neoplasm formation have not been identified. It was also not possible to establish which factors can lead to its malignant degeneration. Therefore, preventive recommendations will be general:
- giving up bad habits (abuse of alcohol and smoking);
- proper nutrition (sufficient intake of vitamins and minerals from food, refusal of fast food, convenience foods and other junk food);
- adequate exercise;
- maintaining a he althy weight;
- timely elimination of hormonal disorders;
- avoiding stress;
- regular visits to the gynecologist.
The fair sex is wondering how often to visit a gynecologist. Women and girls of any age should come for a preventive appointment at least once a year, even if there are no alarming symptoms and they feel great. After 40 years, this must be done 2 times a year, since at this age the risk of developing gynecological pathologies increases.
Brenner's tumor has not been studied enough, various causes and factors contribute to its appearance. Often this diagnosis is unexpected for a woman and makes her panic. To avoid such situations, you must constantly take care of your he alth by regularly visiting a doctor. And if you suspect the development of pathology, listen to the doctor's recommendations and start treatment with all responsibility.
