Iranian Journal of Pathology

A Bilateral Wolffian Adnexal Tumor with Malignant Behavior: A Rare Case Report with Literature Review

Document Type : Case Reports

Authors

Shabnam Mashhadi 1
Fereshteh Ameli 1
Shahrzad Sheikhhasani 2
Sara Parviz 3
Fatemeh Nili 1
Behnaz Jahanbin 1
Arezoo Esmailzadeh 4

1 Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Obstetrics and Gynecology, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2024.1999797.3095
Abstract
Wolffian adnexal tumors (FATWOs) originate from the mesonephric duct remnants. FATWOs are extremely rare, and 100 incidental FATWOs have been reported in English literature. Most FATWOs have a low potential for malignancy, but aggressive behavior, including recurrence and metastasis, has been described in a few cases; There is no standard protocol for optimal treatment of FATWOs. The case described here is a 35-year-old female who presented with a right-side ovarian mass via abdominal ultrasound. She had a history of left salpingo-oophorectomy due to an abdominal mass, which both histopathologic and immunohistochemical study’s findings were consistent with  Wolffian tumor. Later, she underwent total abdominal hysterectomy with tumor debulking because of the probable malignant behavior of the tumor. FATWO has a heterogeneous histologic pattern,which may make its diagnosis challenging. No specific immunohistochemical markers have yet been recognized for FATWO and pathogenesis or molecular alterations are not definitive.  Therefore, there is no comprehensive recommendation for optimal clinical management of FATWO or its recurrence.

Keywords

Bilateral Wolffian
Adnexal Tumor
Malignant Behavior
Case Report

Subjects

  1. Kariminejad MH, Scully RE. Female adnexal tumor of probable Wolffian origin. A distinctive pathologic entity. Cancer. 1973;31(3):671-7. [PMID] [DOI:10.1002/1097-0142(197303)31:33.0.CO;2-K]
  2. Chen Q, Shen Y, Xie C. Recurrent and metastatic female adnexal tumor of probable Wolffian origin: A case report and review of the literature. Medicine. 2021;100(13). [DOI:10.1097/MD.0000000000025377] [PMID]
  3. Bunnell ME, Donovan BM, Parrack PH, Muto MG, Horowitz NS, Leung SOA. Female adnexal tumor of probable Wolffian Origin-A report of two cases at one institution. Gynecol Oncol Rep. 2020;33. [DOI:10.1016/j.gore.2020.100612] [PMID]
  4. Liu L, Fang Q, Xing Y. Female adnexal tumor of probable Wolffian origin arising from mesosalpinx: a case report and review. J Obstet Gynaecol Res. 2018;44(9):1859-63. [DOI:10.1111/jog.13704] [PMID]
  5. Syriac S, Durie N, Kesterson J, Lele S, Mhawech-Fauceglia P. Female Adnexal Tumor of Probable Wolffian Origin (FATWO) With Recurrence 3 Years Postsurgery: C-kit Gene Analysis and a Possibility of a New Molecular Targeted Therapy. Int J Gynecol Pathol. 2011;30(3):231. [DOI:10.1097/PGP.0b013e3182005340] [PMID]
  6. Herrington CS. WHO Classification of Tumours Female Genital Tumours: International Agency for Research on Cancer; 2020.
  7. Nucci MR, Parra-Herran C. Gynecologic Pathology E-Book: A Volume in the Series: Foundations in Diagnostic Pathology: Elsevier Health Sciences; 2019.
  8. Harada O, Ota H, Takagi K, Matsuura H, Hidaka E, Nakayama J. Female adnexal tumor of probable Wolffian origin: Morphological, immunohistochemical, and ultrastructural study with c‐kit gene analysis. Pathol Int. 2006;56(2): 95-100. [DOI:10.1111/j.1440-1827.2006.01930.x] [PMID]
  9. Hong S, Cui J, Li L, Buscema J, Liggins C, Zheng W. Malignant female adnexal tumor of probable Wolffian origin: case report and literature review. Int J Gynecol Pathol. 2018;37(4):331-7. [DOI:10.1097/PGP.0000000000000422] [PMID]
  10. Atallah D, Rouzier R, Voutsadakis I, Sader-Ghorra C, Azoury J, Camatte S, et al. Malignant female adnexal tumor of probable Wolffian origin relapsing after pregnancy. Gynecol Oncol. 2004;95(2):402-4. [DOI:10.1016/j.ygyno.2004.07.042] [PMID]
  11. Sinha R, Bustamante B, Tahmasebi F, Goldberg GL. Malignant Female Adnexal Tumor of Probable Wolffian Origin (FATWO): A case report and review for the literature. Gynecol Oncol Rep. 2021 Feb 9; 36:100726. [DOI:10.1016/j.gore.2021.100726] [PMID]
  12. Chen Q, Shen Y, Xie C. Recurrent and metastatic female adnexal tumor of probable Wolffian origin: A case report and review of the literature. Medicine (Baltimore). 2021;100(13):e25377. [DOI:10.1097/MD.0000000000025377] [PMID]
  13. Ramirez PT, Wolf JK, Malpica A, Deavers MT, Liu J, Broaddus R. Wolffian duct tumors: case reports and review of the literature. Gynecologic oncology. 2002;86(2):225-30. [DOI:10.1006/gyno.2002.6739] [PMID]
  14. Kommoss F, Oliva E, Bhan AK, Young RH, Scully RE. Inhibin expression in ovarian tumors and tumor-like lesions: an immunohistochemical study. Mod Pathol. 1998;11(7):656-64.
  15. Wakayama A, Matsumoto H, Aoyama H, Saio M, Kumagai A, Ooyama T, et al. Recurrent female adnexal tumor of probable Wolffian origin treated with debulking surgery, imatinib and paclitaxel/carboplatin combination chemotherapy: a case report. Oncol Lett. 2017;13(5):3403-8. [DOI:10.3892/ol.2017.5874] [PMID]
  16. Lešin J, Forko-Ilić J, Plavec A, Planinić P. Management of Wolffian duct tumor recurrence without chemotherapy. Arch Gynecol Obstet. 2009;280(5):855-7. [DOI:10.1007/s00404-009-1024-1] [PMID]
Iranian Journal of Pathology
Volume 19, Issue 4
Autumn 2024
Pages 453-459

  • Receive Date 18 April 2024
  • Revise Date 19 October 2023
  • Accept Date 02 October 2024

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