Brenner Tumor of the Ovary in a Patient With Postmenopausal Bleeding: A Case Report

Brenner tumors are ovarian epithelial tumors that can be benign, borderline, or malignant. This report highlights a case of a patient with postmenopausal bleeding and elevated estradiol associated with a Brenner tumor. A 59-year-old woman, menopausal for seven years, presented with postmenopausal bleeding for the past month. An ultrasound done four years prior to presentation revealed a right adnexal mass likely to be a fibrous lesion. An office endometrial biopsy done at the time of presentation showed a weakly proliferative endometrium. The patient was then prescribed a course of medroxyprogesterone acetate therapy. Because of persistent bleeding, the patient was scheduled for a hysteroscopy and dilation and curettage. An exam under anesthesia confirmed a firm, palpable mass in the right adnexa and a normal uterine cavity. Endometrial curetting indicated proliferative endometrium. After hysteroscopy and biopsy, a pelvic sonogram showed a 5.8 x 4.3 x 4.2 cm solid right adnexal mass. Serum estradiol was measured at 137.0 pg/mL. The patient was then scheduled for a laparoscopic hysterectomy with bilateral salpingo-oophrectomy, with final pathology of the right adnexal mass revealing a Brenner tumor. The patient had an uncomplicated postoperative course. Patients with persistent postmenopausal bleeding require further evaluation; if not caught early, postmenopausal estrogen production by tumors may be associated with concomitant endometrial cancer.