From morphology to methylome: epigenetic studies of Müllerian mesonephric-like adenocarcinoma reveal similarities to cervical mesonephric adenocarcinoma†.

Mesonephric adenocarcinomas (MAs) and mesonephric-like adenocarcinomas (MLAs) are rare, aggressive neoplasms that arise in the gynecologic tract and show overlapping morphologic, immunohistochemical, and molecular features. While MAs occur in the cervix and are thought to arise from mesonephric remnants, MLAs occur in the endometrium and ovary and are believed to originate from transdifferentiation of Müllerian lesions. Both MAs and MLAs show a variety of architectural patterns, exhibit frequent expression of GATA3 by immunohistochemistry, and harbor KRAS mutations. In a recent article published in The Journal of Pathology, Kommoss and colleagues used DNA methylation profiling to extend these similarities and showed that MLAs and MAs cluster together based on their epigenetic signatures and are epigenetically distinct from other Müllerian adenocarcinomas. They also showed that MLAs and MAs harbor a high number of global copy number alterations. This study provides evidence that MLAs more closely resemble MAs than Müllerian carcinomas on an epigenetic level. As a result, the authors argue that MLA should be renamed 'mesonephric-type adenocarcinoma.' Further research is needed to establish the relationship between these two entities, their etiology, and pathogenesis. © 2024 The Pathological Society of Great Britain and Ireland.

[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.

Tumor do seio endodérmico do ovário: relato de um caso / Endodermal sinus tumor of the ovary: a case report

Apresenta-se um caso de tumor do seio endodérmico do ovário, observado na Clínica Ginecológica do Hospital da Lagoa, entre junho de 1963 a outubro de 1984. Tecem-se, ao mesmo tempo, consideraçöes sobre a raridade, diagnóstico, tratamento, agressividade e prognóstico da neoplasia, à luz dos recursos mais atualizados

Adenocarcinoma de células claras (tipo mesonefroma) de colo uterino / Clear-cell adenocarcinoma (type mesonephroma) of the cervix uteri

Apresenta-se breve história do adenocarcinoma de células claras do colo uterino, descreve-se sua evoluçäo clínica, tratamento e relata-se um caso

Tumor do seio endodérmico: apresentaçäo de um caso / Endodermal sinus tumor: report of a case

Apresenta-se um caso de tumor raro ovariano de linhagem germinativa que é o tumor de seio endodérmico, em uma paciente com 11 anos de idade. Sua queixa era aumento do volume abdominal com evoluçäo rápida. Optou-se pela laparotomia exploradora onde se encontrou tumor sólido-cístico com áreas de hemorragia, medindo aproximadamente 18 x 18 cm, sendo realizada anexectomia unilateral. O exame histopatológico revelou tumor de seio endodérmico. Em vista disto foi realizada uma segunda laparotomia (histerectomia total + anexectomia) contralateral e omentectomia. O tratamento foi complementado com poliquimioterapia (vimblastina - bleomicina - cisplatinum). Porém na terceira série a paciente recusou-se a continuar o tratamento. Um ano após a cirurgia a paciente encontra-se assintomática e sem sinais clínicos e laboratoriais de recidivas ou metástases

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

Tumor del seno endodérmico en un paciente portador de una disgenesia gonadal / Endodemal sinus tumors in a patient with gonadal dysgenesia

Se presenta un caso de tumor del seno endodermal en un paciente de 14 años de edad, portador de un cuadro de disgenesia gonadal

Valor diagnóstico da estrutura de Schiller-Duval no tumor do seio endodérmico / Diagnostic value of the Schiller-Duval structure in endodermal sinus tumor

Tecem-se consideraçöes histológicas sobre o tumor do seio endodérmico baseado em dois casos desta neoplasia com localizaçäo ovariana e em um caso originado primariamente no testículo de um recém-nascido. O tumor apresenta um quadro histológico bastante complexo o que torna muitas vezes difícil sua caracterizaçäo. Chama-se a atençäo para as estruturas de Schiller-Duval, bem como para os glóbulos hialinos de localizaçäo intra e extracelular, que representam elementos de extrema importância diagnóstica na caracterizaçäo deste tumor

Tumor del seno endodérmico de la nasofaringe en niños con teratoma maduro previo / Endodermal sinus tumor of the nasopharynx in children with previous mature teratoma

Se presentan dos ejemplos de tumor del seno endodérmico desarrollados en la rinofaringe meses a años después de haberse detectado una masa teratomatosa en esa región. El primer caso sucedió en un recién nacido con dificultad respiratoria debida a un teratoma nasofaríngeo que fue extirpado. Los síntomas reaparecieron 2 años después, a causa de un tumor del seno endodérmico en la misma ubicación. En el segundo la masa tumoral inicial fue detectada a los 7 meses de edad y el tumor del seno endodérmico cinco meses mas tarde. En ambos casos el teratoma inicial estaba compuesto predominantemente por tejido nervioso. Este fenómeno reproduce el mas conocido de aparición de un tumor del seno endodérmico en el teratoma sacrococcígeo. Dado que el diagnóstico diferencial de las lesiones rinofaríngeas conteniendo tejido nervioso depende de una cuidadosa correlación anatómica, clínica y radiológica no siempre fácil de lograr, se sugiere el seguimiento de las mismas mediante el dosaje de alfa-fetoproteína sérica como marcador del TSE