双侧卵巢恶性Brenner瘤伴肝肠转移1例并文献回顾

Malignant Brenner Tumor of Bilateral Ovaries with Hepatic and Intestinal Metastasis: A Case Report and Literature Review

摘要: 目的：探讨卵巢恶性Brenner瘤(malignant Brenner tumor, MBT)的临床病理特征、诊疗方法及预后，结合文献回顾完善临床对该病的临床认知。方法：回顾性分析1例双侧卵巢恶性Brenner瘤伴肝肠转移患者的临床资料，并回顾近年国内外相关文献，结果：患者年龄51岁，临床表现为上腹痛，自扪及左下腹包块，病理诊断为左侧卵巢恶性Brenner瘤伴囊性变，侵及同侧输卵管组织，右侧卵巢恶性Brenner瘤，乙状结肠及部分直肠等符合转移性低分化癌，来源于卵巢恶性Brenner瘤，分子检测示BRCA1/2突变，术后给予“紫杉醇脂质体240 mg联合卡铂400 mg”方案化疗6次，不规律口服奥拉帕利2月，后自行停药，停药3年后复发。结论：卵巢恶性Brenner瘤较罕见，无特异性临床表现，缺乏特异性诊疗指标，易漏诊误诊，确诊依赖病理及免疫表型；预后较差，需积累更多病例及长期随访数据，优化诊疗策略。

Abstract: Objective: To investigate the clinical-pathological characteristics, diagnostic and therapeutic approaches, and prognosis of malignant Brenner tumor (MBT) of the ovary, and to enhance clinical awareness and management of this rare disease through literature review. Methods: A retrospective analysis was conducted on the clinical data of a patient with bilateral ovarian MBT and hepatic and intestinal metastases, combined with a review of recent domestic and international literature. Results: The patient was 51 years old, presenting with epigastric pain and a palpable mass in the left lower abdomen. Pathological diagnosis revealed left ovarian MBT with cystic changes, invasion of the ipsilateral fallopian tube, and right ovarian MBT. The sigmoid colon and partial rectum exhibited metastatic poorly differentiated carcinoma, originating from ovarian MBT. Molecular testing identified BRCA1/2 mutations. Postoperatively, the patient received intravenous chemotherapy with “paclitaxel liposome 240 mg + carboplatin 400 mg” for 6 cycles, followed by intermittent oral olaparib for 2 months before discontinuation. Recurrence occurred 3 years after discontinuation. Conclusion: Ovarian MBT is relatively rare, lacks specific clinical manifestations, and has no definitive diagnostic markers, making it prone to missed or misdiagnosis. Definitive diagnosis relies on pathological and immunophenotypic features. The prognosis is poor, necessitating further case accumulation and long-term follow-up data to optimize diagnostic and therapeutic strategies.