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Lennartz M, Csomós H, Chirico V, Weidemann S, Gorbokon N, Menz A, Büscheck F, Hube-Magg C, Höflmayer D, Bernreuther C, Blessin NC, Lebok P, Sauter G, Steurer S, Burandt E, Dum D, Krech T, Simon R, Minner S, Jacobsen F, Clauditz TS, Luebke AM, Siraj AK, Al-Dayel F, Al-Kuraya KS, Hinsch A. Cadherin-16 (CDH16) immunohistochemistry: a useful diagnostic tool for renal cell carcinoma and papillary carcinomas of the thyroid. Sci Rep 2023; 13:12917. [PMID: 37558687 PMCID: PMC10412623 DOI: 10.1038/s41598-023-39945-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023] Open
Abstract
Cadherin-16 (CDH16) plays a role in the embryonal development in kidney and thyroid. Downregulation of CDH16 RNA was found in papillary carcinomas of the thyroid. To determine the expression of CDH16 in tumors and to assess the diagnostic utility a tissue microarray containing 15,584 samples from 152 different tumor types as well as 608 samples of 76 different normal tissue types was analyzed. A membranous CDH16 immunostaining was predominantly seen in thyroid, kidney, cauda epididymis, and mesonephric remnants. In the thyroid, CDH16 staining was seen in 100% of normal samples, 86% of follicular adenomas, 60% of follicular carcinomas, but only 7% of papillary carcinomas (p < 0.0001). CDH16 positivity was frequent in nephrogenic adenomas (100%), oncocytomas (98%), chromophobe (97%), clear cell (85%), and papillary (76%) renal cell carcinomas (RCCs), various subtypes of carcinoma of the ovary (16-56%), various subtyped of carcinomas of the uterus (18-40%), as well as in various subtypes of neuroendocrine neoplasms (4-26%). Nineteen further tumor entities showed a weak to moderate CDH16 staining in up to 8% of cases. Our data suggest CDH16 as a potential diagnostic marker-as a part of a panel-for the identification of papillary carcinomas of the thyroid, nephrogenic adenomas, and the distinction of renal cell tumors from other neoplasms.
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Affiliation(s)
- Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Henrietta Csomós
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Viktoria Chirico
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Niclas C Blessin
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Abdul Khalid Siraj
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fouad Al-Dayel
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Khawla S Al-Kuraya
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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PARK SUJIN, PARK EUNHYANG, KIM HYUNSOO. Mesonephric-like Carcinosarcoma of the Uterine Corpus: Clinicopathological, Molecular and Prognostic Characteristics in Comparison With Uterine Mesonephric-like Adenocarcinoma and Conventional Endometrial Carcinosarcoma. Cancer Genomics Proteomics 2022; 19:747-760. [PMID: 36316041 PMCID: PMC9620445 DOI: 10.21873/cgp.20357] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/AIM This study aimed to investigate the clinicopathological, prognostic and molecular characteristics of uterine mesonephric-like carcinosarcoma (MLCS). PATIENTS AND METHODS We collected clinical, pathological, and genetic information from 12 MLCS patients, and analyzed their differences from mesonephric-like adenocarcinoma (MLA) and conventional endometrial carcinosarcoma (CECS). RESULTS The epithelial component was exclusively MLA in all MLCS cases. Metastatic and recurrent tumors consisted predominantly or exclusively of MLA in the majority of MLCS cases. Patients with MLCS and MLA presented with more advanced-stage disease than those with CECS. They also exhibited post-treatment recurrence and lung metastases more frequently than CECS. Disease-free survival rates of MLCS and MLA were shorter than those of CECS. Tumor protein 53 gene mutations were detected in four MLCS cases. CONCLUSION The predominance or exclusive presence of MLA in metastatic and recurrent tumors highlights the possibility that MLA may determine the clinical outcomes of patients with MLCS. Further studies are required to provide direct molecular evidence of the monoclonal origin of uterine MLCS.
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Affiliation(s)
- SUJIN PARK
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - EUNHYANG PARK
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - HYUN-SOO KIM
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Shu X, Zhou Y, Wei G, Chen X, Qiu M. Cervical Carcinosarcoma: Current Understanding on Pathogenesis, Diagnosis, Management and Future Perspectives. Clin Med Insights Oncol 2022; 15:11795549211056273. [PMID: 35153524 PMCID: PMC8826264 DOI: 10.1177/11795549211056273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/10/2021] [Indexed: 02/05/2023] Open
Abstract
Cervical carcinosarcoma (CCS) is a rare aggressive tumor which was referred to as
a sarcoma initially with its morbidity less than 1% of all cervical cancers.
Four theories have been proposed for the pathogenesis of CCS. The “metaplastic
theory,” also called “monoclonal theory,” has been widely accepted so far. The
most common clinical symptom of CCS is abnormal vaginal bleeding. CCS is much
less common than the counterparts in uterine corpus and usually confused with
uterine carcinosarcoma (UCS) or common cervical cancer. The management for CCS
has been mainly extrapolated from studies of UCS or cervical cancers. However,
CCS has its special anatomical position and biological behaviors and is usually
diagnosed at an early stage than UCS. Currently, there is no consensus on the
survival, management and prognosis factors of CCS. We reviewed and summarized
the literatures regarding to the epidemiology, clinical presentations,
pathogenesis, diagnosis and treatment of CCS for providing clinicians with
comprehensive information to diagnose and treat this malignancy.
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Affiliation(s)
- Xinyao Shu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuwen Zhou
- Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Guixia Wei
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaorong Chen
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Qiu
- Department of Abdominal Cancer, Cancer Center, West China Hospital of Sichuan University, Chengdu, China
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Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors. Diagnostics (Basel) 2021; 11:diagnostics11112042. [PMID: 34829389 PMCID: PMC8625485 DOI: 10.3390/diagnostics11112042] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023] Open
Abstract
Mesonephric-like adenocarcinoma (MLA) of the uterine corpus is a rare but distinct malignant tumor of the female genital tract, demonstrating a characteristic morphology and unique immunohistochemical profiles and molecular alterations. We conducted immunohistochemical staining (IHC) to make precise differential diagnoses of uterine MLAs from common histological subtypes of endometrial carcinomas. We collected 25 uterine MLAs and performed IHC for GATA3, TTF1, CD10, ER, PR, p16, p53, and HER2. Seventeen cases (68.0%) showed at least moderate nuclear GATA3 immunoreactivity in ≥25% of tumor cells. Most cases expressed TTF1 (17/21, 81.0%) and CD10 (luminal; 17/21, 81.0%). Heterogeneous TTF1 expression was noted in 12 cases. An inverse pattern of GATA3 and TTF1 staining was observed in eight cases (32.0%). Three cases (12.0%) showed moderate-to-strong ER expression in ≥25% of tumor cells, and two cases (8.0%) showed moderate-to-strong PR expression in ≥5% of tumor cells. These hormone receptor-positive MLAs varied in intensity and proportion of GATA3 staining. None of the 25 cases exhibited either diffuse and strong p16 expression or aberrant p53 expression. Five cases (20.0%) showed equivocal HER2 immunoreactivity (score 2+), but HER2 FISH confirmed that none of them exhibited HER2 gene amplification. In summary, a small subset of uterine MLAs displayed atypical IHC results: focal but strong expression of ER or PR, the complete absence of GATA3 immunoreactivity, the concurrent expression of mesonephric and hormone receptors, and the inverse pattern of GATA3 and TTF1 staining. These unusual immunophenotypes may complicate the differential diagnosis of MLA. Moreover, pathologists should be encouraged to interpret the IHC results cautiously.
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da Silva EM, Fix DJ, Sebastiao APM, Selenica P, Ferrando L, Kim SH, Stylianou A, Da Cruz Paula A, Pareja F, Smith ES, Zehir A, Konner JA, Cadoo K, Reis-Filho JS, Abu-Rustum NR, Mueller JJ, Weigelt B, Park KJ. Mesonephric and mesonephric-like carcinomas of the female genital tract: molecular characterization including cases with mixed histology and matched metastases. Mod Pathol 2021; 34:1570-1587. [PMID: 33772212 PMCID: PMC8343944 DOI: 10.1038/s41379-021-00799-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022]
Abstract
Mesonephric carcinoma of the cervix is a rare tumor derived from Wolffian remnants. Mesonephric-like carcinomas of the ovary and endometrium, while morphologically similar, do not have obvious Wolffian derivation. Here, we sought to characterize the repertoire of genetic alterations in primary mesonephric and mesonephric-like carcinomas, in the distinct histologic components of mixed cases, as well as in matched primary tumors and metastases. DNA from microdissected tumor and normal tissue from mesonephric carcinomas (cervix, n = 8) and mesonephric-like carcinomas (ovarian n = 15, endometrial n = 13) were subjected to sequencing targeting 468 cancer-related genes. The histologically distinct components of four cases with mixed histology and four primary tumors and their matched metastases were microdissected and analyzed separately. Mesonephric-like carcinomas were underpinned by somatic KRAS mutations (25/28, 89%) akin to mesonephric carcinomas (8/8, 100%), but also harbored genetic alterations more frequently reported in Müllerian tumors. Mesonephric-like carcinomas that lacked KRAS mutations harbored NRAS (n = 2, ovary) or BRAF (n = 1, endometrium) hotspot mutations. PIK3CA mutations were identified in both mesonephric-like (8/28, 28%) and mesonephric carcinomas (2/8, 25%). Only mesonephric-like tumors harbored CTNNB1 hotspot (4/28, 14%) and PTEN (3/13, 23%) mutations. Copy number analysis revealed frequent gains of chromosomes 1q and 10 in both mesonephric (87% 1q; 50% chromosome 10) and mesonephric-like tumors (89% 1q; 43% chromosome 10). Chromosome 12 gains were more frequent in ovarian mesonephric-like carcinomas, and losses of chromosome 9 were more frequent in mesonephric than in mesonephric-like carcinomas (both p = 0.01, Fisher's exact test). The histologically distinct components of four mixed cases were molecularly related and shared similar patterns of genetic alterations. The progression from primary to metastatic lesions involved the acquisition of additional mutations, and/or shifts from subclonal to clonal mutations. Our findings suggest that mesonephric-like carcinomas are derived from a Müllerian substrate with differentiation along Wolffian/mesonephric lines.
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Affiliation(s)
- Edaise M da Silva
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel J Fix
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Ana Paula Martins Sebastiao
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medical Pathology, Federal University of Parana, Curitiba, PR, Brazil
| | - Pier Selenica
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Ferrando
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Sarah H Kim
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anthe Stylianou
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Arnaud Da Cruz Paula
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Evan S Smith
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ahmet Zehir
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jason A Konner
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Karen Cadoo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nadeem R Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer J Mueller
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Kay J Park
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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d’Amati A, Pezzuto F, Serio G, Marzullo A, Fortarezza F, Lettini T, Cazzato G, Cormio G, Resta L. Mesonephric-Like Carcinosarcoma of the Ovary Associated with Low-Grade Serous Carcinoma: A Case Report. Diagnostics (Basel) 2021; 11:diagnostics11050827. [PMID: 34063676 PMCID: PMC8147621 DOI: 10.3390/diagnostics11050827] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023] Open
Abstract
Mesonephric adenocarcinomas are rare tumors of the female genital tract, thought to arise from embryonic mesonephric remnants, primarily in the cervix and vagina. Conversely, endometrial and ovarian mesonephric adenocarcinomas may have a different pathogenesis, probably originating from transdifferentiated Müllerian carcinomas, as demonstrated by the association of these neoplasms with endometriosis and ovarian serous tumors. For this reason, in the endometrium and in the ovary, they are defined as "mesonephric-like adenocarcinomas". Some cases of mesonephric carcinomas of the female genital tract have been reported to show a sarcomatous component and have been defined as "mesonephric carcinosarcomas", characterized by poor prognosis and high metastatic behavior, but this entity has never been described in the ovary. The case herein presented is of a 74-year-old female with abdominal discomfort and a complex ovarian mass. Histological and immunohistochemical analysis showed features of ovarian mesonephric-like carcinoma combined with a low-grade serous component, in support of the theory of a Müllerian origin of these neoplasms. The tumor also revealed foci of chondrosarcomatous differentiation, never before reported in the ovary, showing a similar immunohistochemical profile to the mesonephric-like elements. This work thus describes the first reported case of ovarian mesonephric-like carcinosarcoma.
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Affiliation(s)
- Antonio d’Amati
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.P.); (F.F.)
| | - Gabriella Serio
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
- Correspondence:
| | - Andrea Marzullo
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
| | - Francesco Fortarezza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy; (F.P.); (F.F.)
| | - Teresa Lettini
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
| | - Gerardo Cazzato
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
| | - Gennaro Cormio
- Department of Biomedical Sciences and Medical Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.d.); (A.M.); (T.L.); (G.C.); (L.R.)
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Reis-de-Carvalho C, Vaz-de-Macedo C, Ortiz S, Colaço A, Calhaz-Jorge C. Cervical Mesonephric Adenocarcinoma: A Case Report of a Rare Gynecological Tumor from Embryological Remains of the Female Genital Tract. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:329-333. [PMID: 33784759 PMCID: PMC10183855 DOI: 10.1055/s-0041-1725051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Malignant mesonephric tumors are uncommon in the female genital tract, and they are usually located where embryonic remnants of Wolffian ducts are detected, such as the uterine cervix. The information about these tumors, their treatment protocol, and prognosis are scarce. CASE REPORT A 60-year-old woman with postmenopausal vaginal bleeding was initially diagnosed with endometrial carcinoma. After suspicion co-testing, the patient underwent a loop electrosurgical excision of the cervix and was eventually diagnosed with mesonephric adenocarcinoma. She was subjected to a radical hysterectomy, which revealed International Federation of Gynecology and Obstetrics (FIGO) IB1 stage, and adjuvant radiotherapy. The follow-up showed no evidence of recurrence after 60 months. CONCLUSION We present the case of a woman with cervical mesonephric adenocarcinoma. When compared with the literature, this case had the longest clinical follow-up without evidence of recurrence, which reinforces the concept that these tumors are associated with a favorable prognosis if managed according to the guidelines defined for the treatment of patients with cervical adenocarcinomas. Though a rare entity, it should be kept in mind as a differential diagnosis for other cervical cancers.
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Affiliation(s)
- Catarina Reis-de-Carvalho
- Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | | | - Santiago Ortiz
- Department of Pathology, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Anabela Colaço
- Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Carlos Calhaz-Jorge
- Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Jiang LL, Tong DM, Feng ZY, Liu KR. Mesonephric adenocarcinoma of the uterine cervix with rare lung metastases: A case report and review of the literature. World J Clin Cases 2020; 8:1735-1744. [PMID: 32432147 PMCID: PMC7211527 DOI: 10.12998/wjcc.v8.i9.1735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/27/2020] [Accepted: 04/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mesonephric adenocarcinoma (MNA) of the female reproductive system is a rare tumor arising from remnants of the mesonephric duct, which is mainly located in the cervix. MNA often occurs in adult women. Due to the rarity of the disease and few reports, the specific clinical features have not been established.
CASE SUMMARY We present a case of a cervical MNA in a 48-year-old woman with an incidental intra-operative diagnosis who received postoperative chemotherapy. Rare lung metastases were detected during follow-up. The existing literature is reviewed.
CONCLUSION The clinical manifestations, pathological characteristics, diagnosis, treatment, and prognosis of MNA have been summarized through the review of the existing literature and the case in this paper. Due to the rarity of this disease, it is very important for the research of MNA in the future.
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Affiliation(s)
- Li-Li Jiang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - De-Ming Tong
- Department of General Surgery, Northen War General Hospital Heping Branch Hospital, Shenyang 110004, Liaoning Province, China
| | - Zi-Yi Feng
- College of Clinical Medicine Science, China Medical University, Shenyang 110013, Liaoning Province, China
| | - Kui-Ran Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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9
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Ribeiro B, Silva R, Dias R, Patrício V. Carcinosarcoma of the uterine cervix: a rare pathological finding originating from mesonephric remnants. BMJ Case Rep 2019; 12:12/3/e227050. [PMID: 30936330 DOI: 10.1136/bcr-2018-227050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Carcinosarcoma of the uterine cervix is a very rare tumour that has been described in less than 70 cases in the literature. It is less common compared with carcinosarcoma of the uterine corpus and it can have two origins: the Müllerian ducts and the mesonephric duct remnants. The association of mesonephric carcinoma with a sarcomatous component was reported in only 11 cases, including the following. We describe a case of a 64-year-old woman, presenting with vaginal bleeding and a cervical lesion reported as a sarcoma of endometrial stroma in the first biopsy. After exclusion of distant disease, she was submitted to radical surgery and the final histopathological examination showed a carcinosarcoma of the cervix with mesonephric origin.
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Affiliation(s)
- Bárbara Ribeiro
- Gynecology and Obstetrics Department, Hospital de Braga, Braga, Portugal
| | - Raquel Silva
- Pathology, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Renata Dias
- Pathology, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Vanda Patrício
- Gynecology Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
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Mixed Mesonephric Adenocarcinoma and High-grade Neuroendocrine Carcinoma of the Uterine Cervix: Case Description of a Previously Unreported Entity With Insights Into Its Molecular Pathogenesis. Int J Gynecol Pathol 2018; 36:76-89. [PMID: 27532149 DOI: 10.1097/pgp.0000000000000306] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Human papillomavirus (HPV)-negative cervical carcinomas are uncommon and typically encompass unusual histologic subtypes. Mesonephric adenocarcinoma is one such subtype. Mesonephric tumors in the female genital tract are thought to arise from Wolffian remnants, and are extremely rare tumors with widely variable morphology. Sarcomatoid dedifferentiation has been previously described in a few cases, but other forms of dedifferentiation have not been reported. Neuroendocrine carcinoma of the cervix (e.g. small cell carcinoma) is associated with HPV infection, typically HPV 18. These tumors often arise in association with a conventional epithelial component such as squamous cell carcinoma or usual-type endocervical adenocarcinoma. We describe a case of mesonephric adenocarcinoma of the uterine cervix associated with an HPV-negative high-grade neuroendocrine carcinoma at the morphologic and immunophenotypic level, for which we performed targeted massively parallel sequencing analysis of the 2 elements. Both components shared identical mutations in U2AF1 p.R156H (c.467G>A) and GATA3 p.M422fs (c.1263dupG), as well as MYCN amplification. In addition, the neuroendocrine carcinoma harbored TP53 and MST1R mutations not present in the mesonephric carcinoma. Our data suggest a clonal origin of the 2 components of this rare entity, rather than a collision tumor.
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Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma: Meta-analysis of Extremely Rare Tumor of Cervix. Int J Gynecol Cancer 2017; 27:1957-1969. [DOI: 10.1097/igc.0000000000001086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectiveThe aim of this study was to evaluate the prognostic factors, treatment options, and survival outcomes of primary carcinosarcomas of the uterine cervix.MethodsAn electronic search of the literature was conducted from 1951 to February 2017 to identify articles on primary cervical carcinosarcoma. After comprehensive evaluation of case series and case reports, 81 cases were included in the study.ResultsThe most common clinical FIGO (International Federation of Gynecology and Obstetrics) stage was IB at 53% of cases. Median follow-up time was 15 months (range, 1.75–156 months). Two-year disease-free survival (DFS) and overall survival (OS) of the entire cohort were 49% and 60%, respectively. Both 2-year DFS and OS were significantly higher in patients with stage I than in those with stage II disease or greater (73% vs 22%, P = 0.000 and 82% vs 33%, P = 0.000, respectively). Two-year OS was 17% for patients who received primary radiotherapy, whereas it was 68% for those who underwent only surgery (P = 0.003). Surgery followed by adjuvant radiotherapy with or without chemotherapy was significantly associated with improved DFS and OS compared with primary radiotherapy. Two-year DFS was 63% in patients who underwent primary surgery, whereas it was 100% in patients treated with primary surgery followed by adjuvant radiotherapy with chemotherapy (P = 0.030). Stage alone was an independent prognostic factor for risk of both recurrence and death (hazard ratios, 9.8 [P = 0.004] and 14 [P = 0.018], respectively).ConclusionsIn due course of presentation, the tumor stage has a great importance because it is the only independent factor for prognosis. Surgery followed by adjuvant radiotherapy with or without chemotherapy seems to be related with better OS and DFS.
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Lin Y, Chen H, Ye Z, Ding L, Cao Q, Xue L. Synchronous carcinosarcoma of the uterine cervix with adenoid basal carcinoma and cervical intraepithelial neoplasia III: A case report and literature review. Pathol Res Pract 2017; 213:570-573. [DOI: 10.1016/j.prp.2017.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 02/04/2017] [Accepted: 02/05/2017] [Indexed: 11/27/2022]
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Dierickx A, Göker M, Braems G, Tummers P, Van den Broecke R. Mesonephric adenocarcinoma of the cervix: Case report and literature review. Gynecol Oncol Rep 2016; 17:7-11. [PMID: 27354991 PMCID: PMC4898911 DOI: 10.1016/j.gore.2016.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/27/2016] [Accepted: 05/04/2016] [Indexed: 12/24/2022] Open
Abstract
A mesonephric adenocarcinoma of the cervix is a very rare tumor deriving from remnants of the mesonephric duct. Differential diagnosis from other cervical carcinomas is difficult and little is known regarding its biological behavior, prognosis, and the optimal management strategy. We present a case of a mesonephric adenocarcinoma of the cervix with a comprehensive review of the existing literature. In this case a 66-year-old woman presented with postmenopausal vaginal bleeding. She was diagnosed with a FIGO stage IIB mesonephric adenocarcinoma of the cervix and treated with neoadjuvant chemoradiotherapy and a Wertheim hysterectomy. The recovery from surgery was uneventful and the patient remains with no evidence of disease with 2 years of follow-up. A mesonephric adenocarcinoma is a rare tumor deriving from remnants of the Wolffian duct. Challenging diagnosis since this tumor can mimic more common adenocarcinomas. Immunohistochemistry can be helpful in questionable cases. Rational to base treatment on current guidelines for adenocarcinoma until more data. It seems mesonephric carcinomas carry a worse prognosis.
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Affiliation(s)
- A Dierickx
- Department of Gynecology and Obstetrics, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - M Göker
- Department of Gynecology and Obstetrics, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - G Braems
- Department of Gynecology and Obstetrics, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - P Tummers
- Department of Gynecology and Obstetrics, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium
| | - R Van den Broecke
- Department of Gynecology and Obstetrics, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium
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Zhao J, Liu C, Qi JI, Qu P. Mesonephric carcinoma of the uterine corpus: A report of two cases. Oncol Lett 2015; 11:335-339. [PMID: 26870213 DOI: 10.3892/ol.2015.3886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 08/17/2015] [Indexed: 11/05/2022] Open
Abstract
Mesonephric carcinoma of the uterine corpus is an extremely rare malignancy that originates from the mesonephric remnant of the female reproductive tract. There have been no previous reports of mesonephric carcinoma accompanied by a sarcomatous component. The current study presents two cases of uterine corpus mesonephric carcinoma with sarcomatous components that occurred in postmenopausal women. Immunohistochemically, the tumour cells were positive for vimentin and CD10. The tumours of these patients were located in the uterine myometrium; therefore, treatment was similar to that for endometrial cancer. Although the follow-up period was short in the current cases, no metastatic disease was identified in the second case and thus, this may increase clinical knowledge with regard to the biological behavior of these rare malignancies.
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Affiliation(s)
- Jianguo Zhao
- Clinical College of Central Gynecology and Obstetrics, Tianjin Medical University, Heping, Tianjin 300070, P.R. China; Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin 300100, P.R. China
| | - Caiyan Liu
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin 300100, P.R. China
| | - J I Qi
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin 300100, P.R. China
| | - Pengpeng Qu
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin 300100, P.R. China
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Mesonephric carcinosarcoma involving uterine cervix and vagina: report of 2 cases with immunohistochemical positivity For PAX2, PAX8, and GATA-3. Int J Gynecol Pathol 2015; 33:624-9. [PMID: 25272303 DOI: 10.1097/pgp.0000000000000088] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Mesonephric carcinomas are rare tumors predominantly arising in the uterine cervix from mesonephric remnants. Although the tumor has classic morphologic features, some cases can mimic Müllerian adenocarcinoma and be misdiagnosed, especially those with significant ductal pattern. Moreover, there is an overlap in immunohistochemical results with endometrial and endocervical carcinomas. In this study, we report 2 cases of mesonephric carcinosarcoma, originally diagnosed as Müllerian carcinomas, 1 presenting in the vagina; review immunohistochemical results including positivity for GATA-3, not previously reported and comment on the proposed panel of PAX8, p16, and estrogen receptors as discriminators of Müllerian adenocarcinoma (endocervical or endometrial) versus mesonephric carcinoma.
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Carcinosarcoma of the uterine cervix arising from Müllerian ducts. Obstet Gynecol Sci 2015; 58:251-5. [PMID: 26023676 PMCID: PMC4444523 DOI: 10.5468/ogs.2015.58.3.251] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/12/2014] [Accepted: 10/12/2014] [Indexed: 11/08/2022] Open
Abstract
Carcinosarcomas of the uterine cervix are extremely rare. Cervical carcinosarcoma can be characterized by having two different origins: the Müllerian ducts and the mesonephric duct remnants. A 53-year-old Korean woman was admitted to the hospital because of pelvic mass detected on computed tomography scan done at private clinic. A Radical hysterectomy with bilateral salpingooophorectomy and pelvic lymphadenectomy was carried out upon a diagnosis of stage IB2 cervical sarcoma. Immunohistochemically, the epithelial component was positive for pancytokeratin and estrogen receptor, but negative for CD 10 and carletinin. The mesenchymal component was positive for vimentin. The histopathologic diagnosis was a carcinosarcoma of the uterine cervix arising from Müllerian ducts. She underwent chemotherapy. She developed systemic recurrence seven months after operation and died of disease. The origin of cervical carcinosarcoma needs to be verified and immunohistochemical studies using mesonephric marker (CD 10, carletinin, and estrogen receptor) is helpful.
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Jaiman S, Surampudi K, Gundabattula SR, Garg D. Bilateral ovarian metastatic squamous cell carcinoma arising from the uterine cervix and eluding the Mullerian mucosa. Diagn Pathol 2014; 9:109. [PMID: 24899394 PMCID: PMC4071803 DOI: 10.1186/1746-1596-9-109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/18/2014] [Indexed: 12/03/2022] Open
Abstract
Bilateral ovarian metastasis from invasive squamous cell carcinoma of the cervix is a rare phenomenon with very few clinically significant cases described in the literature. Ovarian metastases when present are usually seen in association with bulky, advanced cervical squamous cell carcinomas with extensive involvement of the uterus. We describe a 48 year old woman with clinically normal cervix whose hysterectomy and bilateral salpingo-oophorectomy performed for abnormal uterine bleeding, demonstrated high grade squamous intraepithelial lesion, moderately differentiated squamous cell carcinoma involving the deeper stroma of the uterus and bilateral ovarian metastases. Gross examination of the cervical canal and the uterine cavity did not show tumor while well circumscribed pearly white metastatic deposits were distinguished within the parenchyma of both the ovaries. Microscopy ascertained high grade squamous intraepithelial lesion with malignant cells invading the deeper cervical stroma and disseminating further as lymphovascular tumor emboli within the myometrium of the corpus uteri without involving the endometrium. Both the fallopian tubes exhibited lymphovascular tumor emboli without epithelial involvement while the parenchyma of both the ovaries showed metastatic deposits. Although an isolated case of endophytic squamous cell carcinoma of the cervix with extensive lymphovascular invasion of the corpus uteri, both the fallopian tubes and bilateral ovarian deposits without involving either the endometrium or the tubal mucosa does not form a paradigm, this case brings to light the capricious behavior of cervical squamous cell carcinoma.
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Affiliation(s)
| | | | - Sirisha Rao Gundabattula
- Department of Gynaecology, Fernandez Hospital, Unit 1, 4-1-1230, Bogulkunta, Hyderabad 500001, India.
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Tseng CE, Chen CH, Chen SJ, Chi CL. Tumor rupture as an initial manifestation of malignant mesonephric mixed tumor: a case report and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:1212-1217. [PMID: 24696739 PMCID: PMC3971330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
Malignant mesonephric mixed tumor (MMMT), or mesonephric carcinosarcoma, is a rare tumor with malignant epithelial and mesenchymal components, and is found mostly in the uterine cervix. While diagnosed at the early stage in most cases, MMMT can have an aggressive course. The clinical significance of the presence of sarcomatous components remains unsettled. We report a case of MMMT of the uterine cervix in a patient who presented with tumor rupture, instead of the common presentation, vaginal bleeding. This unusual presentation has not been reported in the literature. It implies that MMMT may progress rapidly without any prodrome and pose a surgical emergency. Unlike most cervical adenocarcinomas, both mesonephric adenocarcinoma and MMMT are not related to human papilloma virus (HPV) infection. Because mesonephric neoplasms have a different etiology, their prevention, screening, and treatment should be further investigated. Thirteen cases of MMMT reported in the literature are also reviewed.
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Affiliation(s)
- Chih-En Tseng
- Department of Pathology, Buddhist Dalin Tzu Chi HospitalChiayi, Taiwan
- School of Medicine, Tzu Chi UniversityHualien, Taiwan
| | - Chien-Han Chen
- Department of Obstetrics and Gynecology, Buddhist Dalin Tzu Chi HospitalChiayi, Taiwan
| | - Shao-Jer Chen
- School of Medicine, Tzu Chi UniversityHualien, Taiwan
- Department of Medical Imaging, Buddhist Dalin Tzu Chi HospitalChiayi, Taiwan
| | - Chen-Lin Chi
- Department of Pathology, Buddhist Dalin Tzu Chi HospitalChiayi, Taiwan
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