Elsevier

Gynecologic Oncology

Volume 103, Issue 3, December 2006, Pages 1155-1158
Gynecologic Oncology

Case Report
Mesonephric adenocarcinoma of the cervix: A case report and review of the literature

https://doi.org/10.1016/j.ygyno.2006.08.031Get rights and content

Abstract

Background.

Malignant mesonephric tumor arising in the uterine cervix is an exceedingly uncommon variant of cervical adenocarcinoma with only 30 well-documented cases in the literature.

Case.

We present a case of a 54-year-old woman with postmenopausal vaginal bleeding who was found to have a stage IB mesonephric adenocarcinoma of the cervix.

Conclusion.

At present there is no consensus on a standardized treatment protocol for malignant mesonephric tumors of the cervix. The present case suggests that a favorable outcome may be achieved for patients with stage IB tumors with aggressive initial therapy.

Introduction

Malignant mesonephric tumors are rare neoplasms derived from remnants of the paired mesonephric (Wolffian) ducts. Little is known regarding optimal therapy or prognosis of mesonephric adenocarcinoma of the cervix, with some suggesting an indolent course with a propensity for multiple recurrences [1], [2], and others an associated aggressive clinical course [3]. Of the 30 well-documented cases of mesonephric tumors of the cervix, clinical outcomes are available for 26 patients [1], [2], [3], [4], [5], [6], [7], [8], [9].

In this report, we describe a patient with mesonephric adenocarcinoma arising in the uterine cervix in whom longer term clinical follow-up was available. A review of the previous cases of malignant mesonephric tumors of the uterine cervix is also presented.

Section snippets

Case report

A 54-year-old Caucasian woman presented with a 4-month history of postmenopausal vaginal bleeding. Physical examination revealed a normal-sized uterus with a friable endocervical polyp. A cervical polypectomy and an endometrial biopsy were performed. Initial pathologic evaluation showed the presence of high grade endometrioid adenocarcinoma in both the endocervical and endometrial specimens. A transvaginal ultrasound described an 8.8 × 4.4 × 3.5 cm uterus with a 7.6-mm endometrial stripe and a

Discussion

Vestigial remnants of the mesonephric ducts are identified in up to 22% of adult cervices [1], [10]. They are not uncommonly encountered deep in the lateral walls of the cervix where they give rise to hyperplasia and, rarely, malignant mesonephric tumors. Table 1 summarizes the 30 cases of malignant mesonephric carcinomas of the cervix thus far reported in the literature. Our patient displayed similarities with the previously reported cases in terms of age and symptoms at presentation and early

References (13)

There are more references available in the full text version of this article.

Cited by (19)

  • Mesonephric adenocarcinoma of the cervix: Case report and literature review

    2016, Gynecologic Oncology Reports
    Citation Excerpt :

    In this literature review 23% of the reported mesonephric carcinomas were associated with a spindled cell component (malignant mixed mesonephric tumor, MMMT). This is a biphasic variant of a mesonephric carcinoma with sarcomatoid features (Clement et al., 1995; Yap et al., 2006). The typical background lesion of a mesonephric carcinoma is florid mesonephric hyperplasia, characterized by a densely eosinophilic luminal secretion (Menon et al., 2013).

  • Neoplastic Lesions of the Cervix

    2011, Surgical Pathology Clinics
    Citation Excerpt :

    Due to the rarity of the tumor, little is known regarding optimal therapy or prognosis. In a review article looking at all published reported cases, local recurrence and distant metastasis were commonly found, including to bone, lung, pleura, abdomen and liver.187 Median and mean times to recurrence were 2.1 and 3.6 years, respectively, and most patients with recurrence died within 1 year, despite therapy.

  • Diverse facets of cervical adenocarcinoma: Comprehensive review of clinicopathologic features and diagnostic criteria

    2010, Diagnostic Histopathology
    Citation Excerpt :

    Papillary proliferations in mesonephric ADC may mimic serous or clear cell adenocarcinoma, however in contrast to these tumours papillary mesonephric adenocarcinoma shows low nuclear grade. Clinical outcome was reported for 31 patients (reviewed by Yap et al.54). Eighty two percent of patients presented with Stage IB tumours and 18% with Stage II–IV tumours.

  • Female reproductive system

    2010, Differential Diagnosis in Surgical Pathology
  • Female reproductive system

    2009, Differential Diagnosis in Surgical Pathology: Expert Consult - Online and Print
View all citing articles on Scopus
View full text