Document Type : Case Reports

Authors

1 Department of Anatomical and Clinical Pathology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Radiation Oncology Research Center (RORC), Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

10.30699/ijp.2020.125459.2375

Abstract

Mesonephric adenocarcinoma of the uterine cervix, an extremely rare tumor of the female genital tract, derives from the remnants of embryonic mesonephric ducts and its prognosis, diagnosis and treatment is rather challenging. We report a case of a 46-year-old woman with history of abnormal uterine bleeding and an enlarged uterine cervix on physical examination without obvious mass lesion. She was clinically underdiagnosed with cervical myoma and mesonephric hyperplasia. After simple hysterectomy, stage IB2 mesonephric adenocarcinoma was diagnosed. Despite adjuvant chemoradiation, she presented with peritoneal and locoregional recurrence in less than a year. In the presence of abnormal bleeding and cervical mass, mesonephric hyperplasia in cervical biopsy specimen should be suspected for adenocarcinoma. Radical hysterectomy and complete staging with or without salpingo-oophorectomy is the mainstay of treatment. Despite all ambiguities, due to small number of the reported cases, the overall prognosis seems to be less favorable than conventional cervical adenocarcinoma.

Keywords

Main Subjects

Ditto A, Martinelli F, Bogani G, Gasparri ML, Donato VD, Paolini B, et al. Bulky mesonephric adenocarcinoma of the uterine cervix treated with neoadjuvant chemotherapy and radical surgery: report of the first case. Tumori. 2016;102(Suppl. 2). [DOI:10.5301/tj.5000386] [PMID]

Abdul-Ghafar J, Chong Y, Han HD, Cha DS, Eom M. Mesonephric Adenocarcinoma of the Uterine Cervix Associated with Florid Mesonephric Hyperplasia: A Case Report. J lifestyle Med. 2013;3(2):117.

Dierickx A, Göker M, Braems G, Tummers P, Van den Broecke R. Mesonephric adenocarcinoma of the cervix: Case report and literature review. Gynecol Oncol reports. 2016;17:7-11. [DOI:10.1016/j.gore.2016.05.002] [PMID] [PMCID]

Menon S, Kathuria K, Deodhar K, Kerkar R. Mesonephric adenocarcinoma (endometrioid type) of endocervix with diffuse mesonephric hyperplasia involving cervical wall and myometrium: an unusual case report. Indian J Pathol Microbiol. 2013;56(1):51. [DOI:10.4103/0377-4929.116150] [PMID]

Robboy SJ, Anderson MC, Russell P. Pathology of the female reproductive tract. Gulf Professional Publishing; 2002.

Erşahin Ç, Huang M, Potkul RK, Hammadeh R, Salhadar A. Mesonephric adenocarcinoma of the vagina with a 3-year follow-up. Gynecol Oncol. 2005;99(3):757-60. [DOI:10.1016/j.ygyno.2005.07.010] [PMID]

Silver SA, Devouassoux-Shisheboran M, Mezzetti TP, Tavassoli FA. Mesonephric adenocarcinomas of the uterine cervix: a study of 11 cases with immunohistochemical findings. Am J Surg Pathol. 2001;25(3):379-87. [DOI:10.1097/00000478-200103000-00013] [PMID]

Tekin L, Yazici A, Akbaba E, Akin MN. Mesonephric adenocarcinoma of the uterine cervix: A case report and review of the literature. J Pak Med Assoc. 2015;65(9):1016-7.

Kenny SL, McBride HA, Jamison J, McCluggage WG. Mesonephric adenocarcinomas of the uterine cervix and corpus: HPV-negative neoplasms that are commonly PAX8, CA125, and HMGA2 positive and that may be immunoreactive with TTF1 and hepatocyte nuclear factor 1-β. Am J Surg Pathol. 2012;36(6):799-807. [DOI:10.1097/PAS.0b013e31824a72c6] [PMID]

Ordi J, Nogales FF, Palacin A, Márquez M, Pahisa J, Vanrell JA, et al. Mesonephric adenocarcinoma of the uterine corpus: CD10 expression as evidence of mesonephric differentiation. Am J Surg Pathol. 2001;25(12):1540-5. [DOI:10.1097/00000478-200112000-00011] [PMID]

Puljiz M, Danolić D, Kostić L, Alvir I, Tomica D, Mamić I, et al. Mesonephric adenocarcinoma of endocervix with lobular mesonephric hyperplasia: case report. Acta Clin Croat. 2016;55(2.):326-9. [DOI:10.20471/acc.2016.55.02.22] [PMID]

Brown S, MacNeil M, Talia K, Longano A. A RARE CASE OF MESONEPHRIC ADENOCARCINOMA OF THE UTERINE CERVIX: A CASE REPORT. Pathol RCPA. 2013;45:S64-5. [DOI:10.1097/01.PAT.0000426868.03329.a8]

Yeo MK, Choi SY, Kim M, Kim KH, Suh KS. Malignant mesonephric tumor of the cervix with an initial manifestation as pulmonary metastasis: case report and review of the literature. Eur J Gynaecol Oncol. 2016;37(2):270-7.