A 48-year-old woman undergoing hysterectomy for fibroids has an incidental 2 cm firm ovarian nodule. Histology shows well-circumscribed nests of urothelium-like cells with longitudinally grooved nuclei set in dense fibrous stroma. What is the diagnosis?
- A Granulosa cell tumour
- B Brenner tumour ✓
- C Fibroma
- D Serous cystadenofibroma
Correct answer: B. Brenner tumour
Explanation
The Brenner tumour is composed of transitional-type (urothelial-like) epithelial nests, classically showing grooved 'coffee bean' nuclei, embedded in abundant fibromatous stroma. It is almost always benign, usually small, solid, and an incidental finding, though it may coexist with a mucinous cystadenoma in the same ovary. A pure fibroma lacks the epithelial nests, and granulosa cell tumours show Call-Exner bodies rather than transitional differentiation.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.