Recurrent malignant Brenner tumor of the ovary with involvement of the urinary bladder: Case report and a brief review of the literature

Brenner tumors (BTs) are an uncommon type of ovarian surface epithelial neoplasm that are mostly benign. Malignant Brenner tumors (MBTs) are rare tumors that makeup < 5% of those of BTs. Recurrence is relatively rare, primarily in the advanced stage. Pelvic organ metastasis or lymph node metastasis is also seen, although less frequently than for other high-grade ovarian carcinomas. We report a 72-year-old woman who presented with lower abdominal pain, vomiting, and gross hematuria. There was also urgency, dysuria, pelvic pressure, and right lower quadrant pain. She had a history of surgical resection of localized MBT without adjuvant therapy. At the current presentation, malignant cells were identified in the urine cytology and ascitic fluid. Imaging studies showed the presence of a solid cystic mass at the site of prior surgery. Surgical staging with optimal cytoreduction was performed with an intraoperative confirmation of the diagnosis of MBT. The tumor was graded as FIGO IIIA1 (T2 N1 M0). The patient was administered adjuvant chemotherapy (carboplatin + paclitaxel and bevacizumab), and close surveillance was carried out. She was alive with no evidence of disease at 28 months of follow-up. This case illustrates an uncommon, yet aggressive pattern of MBT recurrence, underscoring the importance of close long-term monitoring and the value of a multidisciplinary team approach for evaluation and management.