[A Case of Adenocarcinoma, HPV-independent, Mesonephric Type with Significant Response to Neoadjuvant Chemotherapy].

Adenocarcinoma, HPV-independent, mesonephric type (hereafter referred to as "mesonephric carcinoma") arising from the cervix is rare, its treatment has not been established, and its sensitivity to chemotherapy has not been fully investigated. Here we report on a 30-year-old female patient who presented at our hospital with a chief complaint of abnormal genital bleeding. We suspected cervical cancer. Based on examination, biopsy, and imaging, she was diagnosed with stage IIA2 adenocarcinoma of the cervix and was scheduled for surgery. Because she had a SARS-COV-2 infection, she was given two courses of paclitaxel-carboplatin (TC) therapy, based on the then-current surgical risk assessment after SARS-COV-2 infection, with a waiting period of at least 8 weeks. The patient was deemed to have a partial response and was treated with paclitaxel and carboplatin, after which she was deemed to have a partial response and underwent total hysterectomy. A diagnosis of stage IIA2 mesonephric carcinoma, ypT1b2N0M0, was made after histopathologic examination of an excised specimen. The patient was treated with 4 additional courses of TC therapy after surgery, and has had no recurrence in 13 months. We report a first case of response to neoadjuvant chemotherapy with TC regimen in a patient with mesonephric carcinoma of the cervix.

Cervical mesonephric adenocarcinoma: A case report of a rare gynecological tumor from embryological remains of the female genital tract / Adenocarcinoma mesonéfrico cervical: Relato de caso de um tumor ginecológico raro de restos embriológicos do trato genital feminino

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.

Imunohistoquimica no diagnostico do disgerminoma e tumor do seio endodermico do ovario: expressao de citoceratina, alfa-fetoproteina e alfa-antitripsina / Immunohistochemistry in the diagnosis of dysgerminoma and endodermal sinus tumor of ovary: cytokeratin, alpha-fetoprotein and alpha-antitrypsin antibodies expression

Os autores estudaram sete casos de disgerminoma e tres de tumor do seio endodermico do ovario, no intuito de avaliar a utilidade da imunohistoquimica, empregando anticorpos anti-citoceratina, alfa-fetoproteina e alfa-1-antitripsina no diagnostico destes tumores. Os 10 tumores expressaram alfa-1-antitripsina. Nenhum disgerminoma expressou citoceratina enquanto todos os tumores do seio endodermico mostraram reacoes positivas. Os tres tumores do seio endodermico e um disgerminoma expressaram alfa-fetoproteina. Apos investigacao detalhada, este caso foi classificado como um tumor misto de celulas germinativas, tambem por corresponder a um mau prognostico e curta sobrevida, nao muito caracteristico de disgerminomas puros. Este estudo indica que a imunohistoquimica pode ser util no diagnostico destes tipos de tumor, principalmente quando ha areas suspeitas que podem levar a um diagnostico de um tumor misto de celulas germinativas.

A propósito de un caso de tumor del seno endodermal del mediastino y breve revisión de la literatura / A case of endodermal sinue tumor at the mediastinum literature revision

El tumor del Seno Endodermal (TSE) es una neoplasia de las células germinales, de baja presentación en la población general y extraordinariamente rara en el compartimiento mediastinal. En el presente informe se hace referencia de un paciente de 20 años de edad que presentó TSE del mediastino anterior de grandes dimensiones, localmente avanzado y con comportamiento muy agresivo. El diagnóstico se estableció mediante biopsia intratorácica percutánea por aspiración y el paciente recibió quimioterapia combinada con plantino y eptopósido, falleciendo antes de completar el primer curso de tratamiento

Endodermal sinus (Yolk Sac) tumour of the mediastinum

An endodermal sinus tumour of the anterior mediatinum is described in a19-year-old man. This very rare condition is reported for the first time in the Caribbean literature