Mesonephric adenocarcinoma

Editorial Board Member: Kyle Devins, M.D.
Deputy Editor-in-Chief: Gulisa Turashvili, M.D., Ph.D.
Jennifer Pors, M.D.
Lynn Hoang, M.D.

Last author update: 14 July 2023
Last staff update: 14 July 2023

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PubMed Search: Mesonephric adenocarcinoma cervix

Jennifer Pors, M.D.
Lynn Hoang, M.D.
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Cite this page: Pors J, Hoang L. Mesonephric adenocarcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixmesonephricadeno.html. Accessed April 14th, 2024.
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
  • PAX8+, GATA3+, p16-, ER- immunoprofile; TTF1+ in a subset
  • Frequently harbors KRAS mutations
  • 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
  • Cervix, more common in lateral walls
  • Unknown at this time
Clinical features
  • Cervical biopsy, endometrial curettage or hysterectomy specimen
Radiology description
  • MRI demonstrates cervical mass with extension to the uterus, parametrium and upper vagina
Radiology images

Images hosted on other servers:

MRI cervical tumor

Prognostic factors
Case reports
  • 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 pattern

Papillary pattern

Sieve-like pattern

Solid pattern

Mesonephric carcinosarcoma





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 (tubular, glandular and papillary) 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 style 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+, napsin A-
  3. PAX8+, ER+, GATA3-, napsin A-
  4. PAX8+, ER-, napsin A+, AMACR+
Board review style answer #1
B. PAX8+, ER-, GATA3+, napsin A-. Mesonephric carcinomas of the cervix are typically PAX8+, ER-, GATA3+ and napsin A-. Answers A and D are incorrect because they typically show negative to focal staining for napsin A and AMACR.

Comment Here

Reference: Mesonephric adenocarcinoma
Board review style question #2
Which mutation is frequently harbored by mesonephric adenocarcinomas of the cervix?

  1. BRAF
  2. BRCA
  3. KRAS
  4. RET
Board review style answer #2
C. KRAS. Mesonephric adenocarcinomas of the cervix frequently harbor KRAS mutations. Answers A, B and D are incorrect because BRAF, BRCA and RET mutations have not been identified in mesonephric adenocarcinoma of the cervix (Gynecol Oncol Rep 2020;34:100652, Mod Pathol 2021;34:1570, Mod Pathol 2015;28:1504).

Comment Here

Reference: Mesonephric adenocarcinoma
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