Cervix
Carcinoma
Mesonephric adenocarcinoma

Author: Branko Perunovic, M.D. (see Authors page)

Revised: 20 April 2017, last major update May 2007

Copyright: (c) 2007-2017, PathologyOutlines.com, Inc.

PubMed Search: Mesonephric adenocarcinoma [title] cervix

Cite this page: Mesonephric adenocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixmesonephricadeno.html. Accessed October 20th, 2017.
Definition / general
  • Very rare; &60; 50 cases reported
  • Arise from remnants of mesonephric (Wolffian) ducts, which form epididymis and vas deferens in males and persist in females as rete ovarii, paraoophoron and Gartner duct
  • Mean age 52 years, range 35 to 72 years
  • Usually presents with abnormal vaginal bleeding, stage IB disease; some are higher stage and aggressive
  • Adjacent to areas of mesonephric hyperplasia
  • Appears to arise from "lower zone" of Wolffian system, in contrast to female adnexal tumors of probable Wolffian origin (upper zone)
  • Immunophenotype resembles mesonephric remnants of cervix and vagina (EMA+, CK7+, ER-, PR-, Am J Surg Pathol 2001;25:379)
  • May have better prognosis than Müllerian counterparts (Am J Surg Pathol 2004;28:601)
Case reports
Gross description
  • Often along lateral cervix within fibromuscular stroma
Microscopic (histologic) description
  • Small tubules or ducts (most common), also retiform, solid, sex cord like and spindled
  • Glands may be endometrioid
  • May have eosinophilic secretions seen in mesonephric rests
  • Often lined by cuboidal or low columnar cells with malignant nuclei but no intracytoplasmic mucin
  • Mild to moderate nuclear atypia
  • Usually adjacent hyperplastic mesonephric remnants
  • Surface epithelium is not involved
  • Desmoplastic stroma is not prominent
Microscopic (histologic) images

Images hosted on other servers:

Figure 1: 3 cm polypoid mass
2: prominent tubule formation
3: stroma shows minimal desmoplasia
4: CD10+

Positive stains
Negative stains
Differential diagnosis
  • Clear cell carcinoma of mullerian origin: often associated with DES exposure; tubulocytic or papillary pattern with clear and hobnail cells
  • Endometrioid adenocarcinoma: usually high grade, involves surface epithelium and deep cervical stroma, no mesonephric hyperplasia, ER+, PR+, CEA+, vimentin-
  • Malignant mixed mullerian tumor: high grade atypia, distinct demarcation between glandular and stromal components
  • Mesonephric hyperplasia: usually incidental finding with lobular and noninfiltrative patterns, minimal atypia, minimal mitotic activity, no solid/ductal patterns, no angiolymphatic invasion, no necrotic luminal debris
Additional references