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The pathogenesis of atypical proliferative Brenner tumor: an immunohistochemical and molecular genetic analysis.

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Citation: Modern Pathology. 27(2):231-7, 2014 Feb.PMID: 23887305Institution: MedStar Washington Hospital CenterDepartment: PathologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Brenner Tumor/ge [Genetics] | *Cyclin-Dependent Kinase Inhibitor p16/ge [Genetics] | *Ovarian Neoplasms/ge [Genetics] | *Phosphatidylinositol 3-Kinases/ge [Genetics] | *Proto-Oncogene Proteins/ge [Genetics] | *ras Proteins/ge [Genetics] | Brenner Tumor/me [Metabolism] | Brenner Tumor/pa [Pathology] | Cyclin-Dependent Kinase Inhibitor p16/me [Metabolism] | Disease Progression | DNA Mutational Analysis | Female | Humans | Immunohistochemistry | In Situ Hybridization, Fluorescence | Laser Capture Microdissection | Mutation | Ovarian Neoplasms/me [Metabolism] | Ovarian Neoplasms/pa [Pathology] | Phosphatidylinositol 3-Kinases/me [Metabolism] | Proto-Oncogene Proteins/me [Metabolism] | ras Proteins/me [Metabolism] | Reverse Transcriptase Polymerase Chain ReactionYear: 2014 ISSN:

0893-3952

Name of journal: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, IncAbstract: Brenner tumors are ovarian tumors, usually benign, containing epithelium that resembles transitional epithelium. As with other epithelial tumors there exist frankly malignant tumors and tumors that display greater proliferation than the benign Brenner tumors but lack destructive infiltrative growth, and these have been designated 'atypical proliferative' (borderline) Brenner tumors. There have been no well-documented cases of atypical proliferative Brenner tumors that have exhibited malignant behavior. Based on shared morphologic features it is generally believed that atypical proliferative Brenner tumors develop from benign Brenner tumors. The aim of the present study was to confirm this impression by investigating the immunohistochemical and molecular genetic features of benign and atypical proliferative Brenner tumors. Immunohistochemical staining for p16, fluorescence in-situ hybridization (FISH) for CDKN2A (p16-encoding gene) and mutational analysis of the genes commonly mutated in ovarian tumors were performed. p16 immunostaining was positive in the epithelial component of 12 (92%) of 13 benign Brenner tumors, but completely negative in all 7 atypical proliferative Brenner tumors. FISH identified homozygous deletion of CDKN2A in the epithelial component of all atypical proliferative Brenner tumors, but CDKN2A was retained in all benign Brenner tumors. Two PIK3CA somatic mutations were detected in the stromal component in 1 (5%) of 20 Brenner tumors and 3 somatic mutations (1 in KRAS and 2 in PIK3CA) were identified in the atypical epithelial component of 2 (29%) of 7 atypical proliferative Brenner tumors. In summary, our findings suggest that loss of CDKN2A and, to a lesser extent, KRAS and PIK3CA somatic mutations have a role in the progression of a benign to an atypical proliferative Brenner tumor.All authors: Ayhan A, Kuhn E, Kurman RJ, Seidman JD, Shih IeMFiscal year: FY2014Digital Object Identifier:

http://dx.doi.org/10.1038/modpathol.2013.142

Date added to catalog: 2014-10-02

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	23887305	Available		23887305

Brenner tumors are ovarian tumors, usually benign, containing epithelium that resembles transitional epithelium. As with other epithelial tumors there exist frankly malignant tumors and tumors that display greater proliferation than the benign Brenner tumors but lack destructive infiltrative growth, and these have been designated 'atypical proliferative' (borderline) Brenner tumors. There have been no well-documented cases of atypical proliferative Brenner tumors that have exhibited malignant behavior. Based on shared morphologic features it is generally believed that atypical proliferative Brenner tumors develop from benign Brenner tumors. The aim of the present study was to confirm this impression by investigating the immunohistochemical and molecular genetic features of benign and atypical proliferative Brenner tumors. Immunohistochemical staining for p16, fluorescence in-situ hybridization (FISH) for CDKN2A (p16-encoding gene) and mutational analysis of the genes commonly mutated in ovarian tumors were performed. p16 immunostaining was positive in the epithelial component of 12 (92%) of 13 benign Brenner tumors, but completely negative in all 7 atypical proliferative Brenner tumors. FISH identified homozygous deletion of CDKN2A in the epithelial component of all atypical proliferative Brenner tumors, but CDKN2A was retained in all benign Brenner tumors. Two PIK3CA somatic mutations were detected in the stromal component in 1 (5%) of 20 Brenner tumors and 3 somatic mutations (1 in KRAS and 2 in PIK3CA) were identified in the atypical epithelial component of 2 (29%) of 7 atypical proliferative Brenner tumors. In summary, our findings suggest that loss of CDKN2A and, to a lesser extent, KRAS and PIK3CA somatic mutations have a role in the progression of a benign to an atypical proliferative Brenner tumor.

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