Cervix
Carcinoma
Mesonephric adenocarcinoma


Topic Completed: 3 September 2019

Revised: 12 December 2019

Copyright: 2007-2019, PathologyOutlines.com, Inc.

PubMed Search: Mesonephric adenocarcinoma[TIAB] cervix

Jennifer Pors, M.D.
Lynn Hoang, M.D.
Page views in 2018: 2,907
Page views in 2019 to date: 3,970
Cite this page: Pors J, Hoang L. Mesonephric adenocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixmesonephricadeno.html. Accessed December 13th, 2019.
Definition / general
  • Rare, nonhuman papillomavirus (HPV) associated cervical neoplasm that is thought to derive from mesonephric / Wolffian remnants
Essential features
  • Shows a variety of morphologic patterns, presenting a risk of misdiagnosis
  • GATA3+, p16-, ER- immunoprofile
  • Frequently harbors KRAS mutations
Terminology
  • Mesonephric carcinoma of the cervix
  • Mesonephric carcinosarcoma of the cervix
  • Mesonephric adenocarcinoma of the cervix
ICD coding
  • ICD-10: C53.9 - malignant neoplasm of cervix uteri, unspecified
Epidemiology
Sites
  • Cervix, more common in lateral walls
  • Rarely uterine corpus, ovary, vagina
Pathophysiology
  • Unknown at this time
Etiology
Clinical features
Diagnosis
  • Cervical biopsy, endometrial curettage or hysterectomy specimen
Radiology images

Images hosted on other servers:

MRI cervical tumor

Prognostic factors
Case reports
Treatment
  • Mainstay of treatment is hysterectomy with or without bilateral salpingo-oopherectomy and pelvic lymph node dissection
  • Roles of neoadjuvant or adjuvant chemotherapy and radiation therapy remain unclear
Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Lynn Hoang, M.D.

Mix of morphologic patterns

Tubular pattern

Tubular pattern with adjacent mesonephric remnants

Tubular pattern with desmoplasia

Ductal
(pseudoendometrioid)
pattern

Ductal pattern


Papillary pattern

Sieve-like pattern

Solid pattern

Mesonephric carcinosarcoma


GATA3+

ER-

TTF1+

CD10+

Wild type p53

Cytology description
Negative stains
Electron microscopy description
Molecular / cytogenetics description
Sample pathology report
  • Uterus (with cervix), fallopian tubes and ovaries, total hysterectomy and bilateral salpingo-oophorectomy:
    • Mesonephric adenocarcinoma (see comment and synoptic report)
    • Comment: This tumor demonstrates several distinct histologic patterns (tubules, glandular and papillary regions) with associated peripheral mesonephric remnants. By immunohistochemistry, this tumor shows diffuse and strong expression of GATA3 and PAX8 and no expression of ER. Taken together, these features are diagnostic of mesonephric adenocarcinoma of the cervix.
Differential diagnosis
Board review question #1
Which immunohistochemical staining profile would you expect in the cervical neoplasm depicted in this image?



  1. PAX8-, ER-, GATA3+, AMACR+
  2. PAX8+, ER-, GATA3+, napsinA-
  3. PAX8+, ER+, GATA3-, napsinA-
  4. PAX8+, ER-, napsinA+, AMACR+
Board review answer #1
B. PAX8+, ER-, GATA3+, napsinA-. Mesonephric carcinomas of the cervix are typically PAX8+, ER-, GATA3+ and napsinA-.

Reference: Mesonephric adenocarcinoma

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Board review question #2
Which mutation is frequently harbored by mesonephric adenocarcinomas of the cervix?

  1. BRAF
  2. BRCA
  3. KRAS
  4. RET
Board review answer #2
C. KRAS. Mesonephric adenocarcinomas of the cervix frequently harbor KRAS mutations.

Reference: Mesonephric adenocarcinoma

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