A Brenner tumor represents an independent proliferation of cells of the ovaries. Benign or malignant progressions may occur here. Benign tumors form cells and demand space, but do not destroy other cells, unlike malignant tumors, in which cancer cells spread more and more, destroying and displacing other cells.
What is a Brenner tumor?
Brenner tumor is a tumor in the ovary area. Most often, this is benign, but it can also develop malignantly, but this is less common (in less than 10 percent of cases). The Brenner tumor got its name from the pathologist Fritz Brenner. The size of the tumor is rather small, so it can often be overlooked even during routine examinations.
Causes
Brenner’s tumor occurs primarily in women of older age after menopause. In many cases, benign (benign) tumors can be seen as a precursor to the development of a malignant (malignant) tumor, but there is no guarantee here that malignant disease of the ovaries will actually follow as a result. The exact potential of benign tumors has not been researched to date and courses have not been precisely documented. This is also due to the fact that benign tumors, like Brenner’s tumor, are often very small and are found rather by chance during other examinations or interventions in the affected area. Causes are not yet sufficiently known; a connection with the (altered) hormonal balance of the woman is possible.
Symptoms, complaints, and signs
Brenner tumor is usually detected as an incidental finding because it usually remains asymptomatic. In most cases, it is a benign tumor of the ovaries, which has little tendency to grow. Therefore, the tumor remains small and therefore does not press on other organs. However, since Brenner’s tumor often produces estrogen, high estrogen levels can often be found even in older patients. Only when it reaches a certain size can it cause abdominal discomfort by displacing other organs. However, this is usually not the case until a benign Brenner tumor degenerates into a malignant one. Malignant degeneration, however, occurs in only about ten percent of cases. Even after malignant transformation, the tumor does not initially cause any symptoms. Only after a long time do non-specific symptoms appear, which could also indicate many other diseases. Thus, a feeling of pressure in the lower abdomen slowly develops, which is often associated with nausea. The pressure of the tumor on neighboring organs can lead to bloating, flatulence, increased urination and constipation. Furthermore, fatigue, exhaustion and poor performance become increasingly apparent. The abdomen swells because more water is stored there. In addition, bleeding occurs after menopause or outside the normal menstrual period. In the late stage, fever and night sweats are also observed in addition.
Diagnosis
Diagnosis is initially made by ultrasound and may reveal changes in the ovaries. However, this is only the beginning. In most cases, laparoscopy (abdominal endoscopy) is necessary to look closely at the tumor and also to take samples for cytologic examination. Immediate removal of the tumor or ovaries may also be considered, and a detailed examination of the tissue is performed afterwards to determine what further measures are necessary. At the same time as the initial examinations, blood is taken to show the laboratory parameters and to assign any elevated tumor markers accordingly to the diagnosis, thus gaining valuable time for a therapy to be initiated.
Complications
Complications occur mainly in patients whose Brenner tumor is malignant (medically malignant). They mostly result from the debilitating treatment methods, such as chemotherapy. Not only do they cause the usual side effects, such as hair loss, nausea and vomiting, but damage to the liver, kidneys, lungs and heart is also possible. Furthermore, problems with blood clotting or blood formation can be observed time and again. With radiation therapy, on the other hand, complications are seen only now and then. Nevertheless, side effects are also possible during and after treatment. Even the formation of a second tumor due to the high radiation exposure cannot be ruled out.However, even with benign (medically benign) Brenner tumors, complications are likely. First, there is a chance – albeit a small one – that the cells of an untreated tumor will degenerate and develop unnoticed into a malignant form of cancer. If this transformation is not detected in time, there is also the possibility of a fatal outcome with this cancer. On the other hand, nowadays benign Brenner tumors are also usually removed surgically. Although this is a routine procedure, complications may still occur due to general anesthesia. The risks range from injuries (larynx or vocal cords) to incorrect intubation. In addition, severe postoperative bleeding and damage to the urinary bladder are possible with ovarian surgery.
When should you see a doctor?
If a tumor is suspected, a doctor should be consulted immediately. Brenner tumors, although often benign, also require observation and symptomatic treatment. Women after menopause and patients who have already had cancer once are particularly at risk. Corresponding risk groups should consult a physician immediately if they experience unusual symptoms. Since tumors on the ovaries do not cause any clear symptoms at an early stage, women of advanced age should also make use of regular preventive medical checkups. A visit to the doctor is recommended at the latest when a feeling of pressure in the lower abdomen is noticed, possibly accompanied by nausea. Other signs that require medical clarification are loss of appetite, constipation or swelling in the abdomen. Bleeding outside of menstruation or after menopause should be examined immediately. The physician can then determine whether the tumor is benign or malignant and promptly initiate treatment. If left untreated, a Brenner tumor can take a severe course and, in the case of a malignant tumor, result in the patient’s death.
Treatment and therapy
Treatment of Brenner tumor is based on several pillars. Ultimately, the tumor is removed in most cases, even if it is the benign form of Brenner tumor. The tumor is known to produce hormones on its own, especially estrogens, thus imbalancing a woman’s hormonal balance. Consequently, undesirable processes would be triggered in the body, which could negatively affect the quality of life. Since it is also not certain that a malignant form will not develop, removal is advised. In the case of the benign form, the problem is usually solved with the removal and subsequent healing after the operation, no further medical measures are required. Regular follow-up is important. In malignant forms, care must be taken to ensure that no tissue remnants of the tumor remain in the body to prevent a new outbreak. Depending on the stage, chemotherapy or radiation therapy may be considered to ensure that the malignant cells are completely destroyed. Sometimes it is only the spread of tumor cells into the abdominal cavity that makes chemotherapy or radiation therapy necessary. Of course, the surgical procedure is performed so carefully that such a subsequent event can be avoided, but even with professional procedures, it cannot be ruled out that tumor cells will nevertheless enter the abdominal cavity. Therapeutic measures are also more and more individualized depending on the stage of a tumor, in order to achieve the best possible for the patient and to improve the quality of life permanently in a fast way.
Outlook and prognosis
The prognosis for Brenner tumor is good in 90% of patients. In these people, the tumor appears benign and can be removed in one surgical procedure. If no further complications occur, the patient is discharged as healthy after cancer treatment. Nevertheless, 10% of patients suffer a less optimistic course of the disease. These patients are diagnosed with a malignant tumor, which in the worst case leads to an early demise of the affected person. If metastases form, the chances of recovery deteriorate immensely. Depending on the size and location of the Brenner tumor, removal of the diseased tissue may involve additional removal of the ovaries as well as the uterus. In the case of malignant Brenner tumor, chemotherapy or radiation is recommended after surgery.These last for several months and represent a significant loss of well-being. Cancer treatment is associated with numerous side effects from which the patient recovers only slowly over a long period. Nevertheless, it leads to the destruction of as many cancer cells as possible and reduces the risk of cancer recurrence. In principle, the benign as well as the malignant tumor may recur at any time. The prognosis outlook does not change if the disease recurs.
Prevention
Unfortunately, there are no specific measures to prevent the development of a Brenner tumor. Women with severe menopausal symptoms and a history of hormonal problems have only a slightly higher risk of developing a Brenner tumor. Only regular and conscientious gynecological examinations can prevent progression and spread, since action can be taken at an early stage and subsequent damage caused by prolonged non-detection is minimized. Once a year, examinations should also be considered here, which may not be included in a health insurance benefit and must be borne by the patient herself. The prognosis for patients with early detection of Brenner’s tumor is over 90% survival rate, which of course is also related to the often benign form. Detected early, Brenner tumor is very treatable.
Follow-up
In the case of a Brenner tumor, there are usually no special aftercare options available to the affected person. In some cases, the disease can also lead to the death of the affected person if it is detected and treated late. For this reason, early diagnosis and treatment of Brenner’s tumor have a very positive effect on the further course of the disease and can prevent further complications. The affected person is dependent on regular examinations in order to detect and treat further tumors or metastases. If the tumors are removed by surgery, the affected person must recover after this procedure and take care of the body. Heavy and strenuous exertion or sports activities should be refrained from in order to accelerate the healing process. Especially in the case of radiation therapy or chemotherapy, unnecessary exertion should be avoided at all costs. Loving care by friends and relatives can also have a positive effect on the further course of the disease. It is not uncommon for contact with other people affected by Brenner’s tumor to be helpful, as this can lead to an exchange of information. In most cases, the patient’s life expectancy is negatively affected by this disease.
What you can do yourself
In most cases, a Brenner tumor is surgically removed. The patient can speed recovery by taking it easy after the procedure and following the doctor’s instructions regarding diet and wound care. Accompanying this, the site of the surgery must be regularly examined by a physician. Close medical monitoring can prevent complications and detect any recurrences at an early stage. Regular follow-up is especially important for malignant tumors. Should the Brenner tumor take a negative course, i.e. form metastases or cause severe discomfort, the patient can seek therapeutic advice. Fears can be worked through in the course of psychological treatment. This often gives patients a new perspective on life. Going to a self-help group is often a good accompanying measure. Talking to other tumor patients not only helps those affected, but also their relatives, who gain a new perspective on the disease. Which therapeutic measures are useful and necessary depends on the patient’s individual situation. Therefore, the first step should be to talk to a doctor, who can put the patient in touch with a suitable therapist or a self-help group.
