Background/Aim: Mesonephric carcinoma (MNC) is a rare but notable entity of the female genital tract. While many researchers have acknowledged and studied MNC, much remains unknown on the characteristics of mesonephric remnant (MNR) or hyperplasia (MNH). There has not been any study examining the molecular features of MNR and MNH so far. The aim of this study was to investigate the clinicopathological and molecular characteristics of ten uterine mesonephric lesions, including two MNRs without atypia, four MNHs without atypia, and three MNHs with atypia. Materials and Methods: We reviewed the electronic medical records and all available slides of ten cases from multiple institutions. Targeted sequencing and array comparative genomic hybridization were performed. Results: Three atypical MNHs displayed nuclear enlargement, mild-tomoderate nuclear pleomorphism, and nuclear membrane irregularity, and harbored pathogenic Kirsten rat sarcoma 2 viral oncogene homolograt sarcoma 2 viral oncogene homolog (KRAS) mutation. Two of those that co-existed with MNC harbored the same sequence alterations as each of their adjacent MNC. One of the three atypical MNHs harbored chromosome 1q gain. Conclusion: Atypical MNH is a potential premalignant lesion in which KRAS mutation and chromosome 1q gain play an important role in the early stage of mesonephric carcinogenesis. The mesonephric duct is a precursor of the male genital tract present during human embryogenesis (1). In males, it gives rise to the internal genitalia, including the epididymides, vasa deferentia, seminal vesicles, and efferent ductules of the testes, whereas in females, it regresses with some remnants persisting in the broad ligament and the uterine cervix (2). Mesonephric remnant (MNR) and hyperplasia (MNH) are not uncommon findings in specimens of conizations and hysterectomies, being reported in up to one-third of resected adult uterine cervices (1). They might also be present within the wall of the vagina and uterine body, as well as the ovarian hilum and mesosalpinx (3). Mesonephric carcinoma (MNC) is a rare malignant neoplasm thought to arise from the embryonal remnants of mesonephric tubules and ducts, comprising less than 1% of all gynecological tract malignancies (4). MNC arises 813 This article is freely accessible online.