A rare case of polyneoplasia of giant Brenner's tumour and pancreatic adenocarcinoma

Brenner's tumours (mucoid fibroadenomas) are rare ovarian epithelial tumours, the incidence of which among ovarian epithelial neoplasms is 1-5%, and among all ovarian tumours - 1.4-2.5%. Their histogenetic origin is not fully understood, but it is believed that they originate from parovarian Walthard's nests. In 30% of cases, mucoid fibroadenomas are associated with other ovarian tumours. Malignant Brenner's tumours, characterised by decreased cellular differentiation, uncontrolled growth with invasion and destruction of neighbouring structures, are an even rarer and more unpredictable scenario faced by gynaecologists and oncologists. The diagnosis of this disease is difficult due to the lack of specific clinical, laboratory and imaging signs. As with any other epithelial ovarian tumours, the main treatment for Brenner's tumours is surgery. Aim - to analyze a clinical case of polyneoplasia of Brenner's tumour and pancreatic adenocarcinoma Clinical case. The clinical case of surgical intervention for right ovarian cyst in a 55-year-old patient is described. Pathological examination revealed that the removed neoplasm was a Brenner's tumour with the formation of a multicompartmental smooth-walled cyst lined with a single-layer metaplastic mucinous epithelium without signs of proliferation. The malignant nature of the tumour was diagnosed on the basis of morphological confirmation of implantation metastasis of the glandular component of the ovarian tumour into the parietal peritoneum of the anterior abdominal wall. The peculiarity of this case is polyneoplasia, namely the development of pancreatic tail adenocarcinoma and abdominal carcinomatosis, diagnosed 17 months after the initial surgical intervention for Brenner's tumor. Conclusions. Brenner's tumour is a rare clinical entity in gynaecological oncology practice. Despite the fact that the vast majority (93-95%) of such mucoid fibroadenomas are benign, the likelihood of malignancy should be carefully assessed and tumor markers should be used in preoperative examination of patients, surgical staging should be performed during surgery, immunohistochemical examination should be used, especially in cases of large tumours. It should also be remembered that Brenner's tumours can be associated with malignant neoplasia of other localisation. This study did not involve any experiments on animals or humans. Written informed consent for treatment and publication of this case was obtained from the patient. No conflict of interests was declared by the authors.