Corded and hyalinized mesonephric-like adenocarcinoma of the uterine corpus: report of a case mimicking endometrioid carcinoma

Patel, Vatsal; Kipp, Benjamin R.; Schoolmeester, J. Kenneth

doi:10.1016/j.humpath.2018.08.018

Cited by 34 publications

(30 citation statements)

References 6 publications

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“…Corded and hyalinized mesonephric-like adenocarcinoma can also mimick CHEC. Differentiating the tumor from CHEC is its heterogeneous architecture resembling mesonephric growth patterns, segments of attenuated epithelium, lack of squamous differentiation, essentially negative hormone receptor expression, considerable positivity for TTF1 and GATA3 [22].…”

Section: Discussionmentioning

confidence: 99%

Corded and hyalinized endometrioid carcinoma: a rare case and review of the literature

Lang

Yuan

et al. 2020

Preprint

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Background Corded and hyalinized endometrioid carcinoma(CHEC) is a rare morphological variation of endometrioid carcinoma(EC) in the endometrium. Reports of CHEC were very limited. We represent the clinical and pathological findings of this rare endometrioid carcinoma in a 26-year-old woman and reviews the literatures updated on CHEC. Case presentation: A 26-year-old woman presented with abnormal vaginal bleeding for 3 months and the initial cervical biopsy revealed a mullerian mixed tumor in another clinic. Abdominopelvic computed tomography revealed a mass in the uterine cavity and cervix, suggesting a malignant tumor. Histologically, the tumor showed a biphasic pattern characterized by an appearance of 2 components, the conventional endometrioid carcinoma component and sex cord-like component with hyalinization. In the areas of sex cord-like elements, the epithelioid and spindle cells were usually seen around the glands, and mostly arranged in cords or trabeculaes, sometimes embedded within a richly hyalinized collagenous or sometimes myxoid matrix. Tumor cells in the sex cord-like region show a different immunohistochemical expression pattern from conventional adenocarcinoma. Cytokeratin(CK) and vimentin are positive in both components, and vimentin shows more diffuse positivity while CK is more restricted and focally expressed in tumor cells in the sex cord-like region. Complete loss of expression of E-cadherin and epithelial membrane antigen(EMA) was seen in tumor cells in the sex cord-like region whereas it was well preserved in the area of conventional adenocarcinoma. Nuclear expression of β-catenin was noted in tumor cells in the sex cord-like region. P53 was focally positive in both components. Based on histological and immunochemical examinations, the patient was diagnosed with CHEC. Conclusions CHEC is not uncommonly mistaken for a wide variety of diseases. It’s of great significance to raise the awareness of CHEC to avoid over-treatment caused by over-diagnosis, especially in young patients and in curettage. We report one case of CHEC in a 26-year-old woman which was misdiagnosed as a mullerian mixed tumor in the initial curettage specimen. The clinicopathologic, light microscopic, immunohistochemical features of this tumor are described and the differential diagnosis is discussed.

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Section: Discussionmentioning

confidence: 99%

Corded and hyalinized endometrioid carcinoma: a rare case and review of the literature

Lang

Yuan

et al. 2020

Preprint

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“…MLAs are usually positive for Paired box protein-8 (PAX8), GATA binding protein 3 (GATA3), thyroid transcription factor 1 (TTF1), CD10 with luminal staining, and are negative for estrogen receptor (ER) and progesterone receptor (PR). However, focal positivity of ER is described by Kolin et al (2/4 cases with weak, patchy or heterogeneous staining [8]), Pors et al (2/5 cases weak to moderate in 10-55% [27]), Ando et al (only a small number of cells (<1%) in the tubular pattern expressed ER [23]), Euscher et al (6/23 cases with ER ranging from 10% up to 40% [6]), Kenny et al [18], Patel et al (weak focal staining in <5% [26]) and Yamamoto et al (very focal [29]). Hence some positivity of ER does not preclude the diagnosis of MLA.…”

Section: Immunohistochemistrymentioning

confidence: 99%

Mesonephric-Like Adenocarcinoma of the Endometrium: Diagnostic Advances to Spot This Wolf in Sheep’s Clothing. A Review of the Literature

Deolet

Dorpe

Vijver

2021

JCM

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Mesonephric-like adenocarcinoma is a recently described rare neoplasm occurring in the uterine corpus and ovary. This under-recognized subtype of carcinoma can be very challenging to diagnose. In mesonephric adenocarcinoma a variety of growth patterns can be present within the same tumor, as a result of which they can be misinterpreted and diagnosed as low-grade endometrioid adenocarcinoma, clear cell carcinoma, or even serous carcinoma and carcinosarcoma. We report a case of mesonephric-like adenocarcinoma misdiagnosed as a low-grade endometrioid endometrial adenocarcinoma that had an early local recurrence and metastasized to the liver and the lungs. Histopathological, immunohistochemical and molecular analysis were performed and compared to published literature, providing a comprehensive overview of the current knowledge. Databases (Pubmed, Web of Science, Google Scholar) were searched with a combination of the following search terms: mesonephric-like, mesonephric, adenocarcinoma, carcinoma, uterine body, uterine corpus, endometrium. Mesonephric-like adenocarcinoma is a difficult-to-diagnose entity. Advanced diagnostics, including improved morphologic, immunohistochemical and molecular knowledge can help develop new therapeutic strategies against this specific subtype of endometrial cancer with an aggressive clinical behavior.

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“…But because of the limited number of cases reported, less is known regarding the clinical outcomes of UB-MNAC. Most publications on UB-MNAC are individual case reports or case series [4,11,21,[30][31][32][33][34][35][36][37][38][39][40][41][42][43] . A recent case series reported 11 cases of UB-MNAC , by investigating the clinicopathologic details, they concluded UB-MNAC displays an aggressive biological behavior, with a tendency to metastasize to the lungs [39] .…”

Section: Introductionmentioning

confidence: 99%

Mesonephric Adenocarcinoma Arising From The Uterine Corpus：Case Reports and Literature Review

Hu¹,

Xu²,

Deng³

et al. 2020

Preprint

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Abstract Background Mesonephric adenocarcinoma (MNAC) is a rare carcinoma which arises from the mesonephric remnant of the gynecologic tract. It mainly occurs in the uterine cervix, barely locates in the uterine corpus, ovarian and vagina. To date, only a few cases of MNAC arising from of the uterine body (UB-MNAC) have been reported, and the clinicopathologic and molecular characteristics of UB-MNAC remain limited. A recent report suggested that series of UB-MNAC should be defined as Mesonephric-like adenocarcinoma carcinomas (MLAC), for they exhibited the classic morphologic features and immunophenotype of mesonephric carcinoma, but occurring outside of the cervix and without convincing mesonephric remnants. Thus, the histogenesis of UB-MNAC is not yet clear, they may originate in Müllerian tissue and exhibits the mesonephric differentiation phenotype, or arise from the mesonephric remnants in the uterine wall.Case presentation To better understand the histogenesis of UB-MNAC, we presented three UB-MNAC cases from west china second university hospital, which exhibited typical morphologic, histologic as well as the immunohistochemical characteristics of MNAC. Notably, among the three cases, two cases arising from the myometrium layer of the uterine corpus found mesonephric remnants around the tumor. By reviewing the published UB-MNAC and UB-MLAC, we found that to our knowledge ,it is the first time finding mesonephric remnants around the MNAC cells in the reported literature, except one case that found mesonephric remnants in the cervix, and the tumors of the three cases were all arising from the myometrium layer, without endometrium involved. Then we compared the clinical characteristics of the UB-MNAC cases arising from the myometrium and endometrium, and the results showed that the two subgroups had most in common in the clinical characteristics except the myometrium subgroup had a higher elevated CA125 level, and this result was in consistent with the Kaplan-Meier survival analysis, which indicated that the myometrium subgroup had a poorer prognosis than the endometrium group. But this need more data and further study such as the molecular analysis.Conclusion Though the pathogenesis of MLAC or MNAC of the uterine corpus is still under debate, according to our cases and the published literatures, We hypothesize two different pathways involved: the MNAC arising from the myometrium not affecting the endometrium may directly develop from the mesonephric remnant, the one occurred in the endometrium may not real mesonephric adenocarcinoma, but more likely arising from mesonephric transformation of Müllerian adenocarcinoma, and is better referred as MLAC. Besides, the two kinds of adenocarcinomas may have different clinical prognosis, while the MNAC arising from the myometrium may have a poorer prognosis than the MLAC originating from the endometrium, although they have identical morphologic and histologic characteristics.

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Corded and hyalinized mesonephric-like adenocarcinoma of the uterine corpus: report of a case mimicking endometrioid carcinoma

Cited by 34 publications

References 6 publications

Corded and hyalinized endometrioid carcinoma: a rare case and review of the literature

Corded and hyalinized endometrioid carcinoma: a rare case and review of the literature

Mesonephric-Like Adenocarcinoma of the Endometrium: Diagnostic Advances to Spot This Wolf in Sheep’s Clothing. A Review of the Literature

Mesonephric Adenocarcinoma Arising From The Uterine Corpus：Case Reports and Literature Review

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