Mesonephric-Like Adenocarcinomas a Rare Tumor: The Importance of Diagnosis

Stefano Restaino (), Giulia Pellecchia, Angelica Tulisso, Chiara Paglietti, Maria Orsaria, Claudia Andreetta, Elena Poletto, Martina Arcieri, Monica della Martina, Anna Biasioli, Laura Mariuzzi, Lorenza Driul, Giovanni Scambia and Giuseppe Vizzielli
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Stefano Restaino: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Giulia Pellecchia: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Angelica Tulisso: Department of Medicine, Pathological Anatomy Section, University of Udine, 33100 Udine, Italy
Chiara Paglietti: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Maria Orsaria: Institute of Pathological Anatomy, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero “Santa Maria della Misericordia”, 33100 Udine, Italy
Claudia Andreetta: Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy
Elena Poletto: Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy
Martina Arcieri: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Monica della Martina: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Anna Biasioli: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Laura Mariuzzi: Medical Area Department, Institute of Pathological Anatomy, Director School of Specialisation in Pathological Anatomy, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, p.le S.Maria della Misericordia, 33100 Udine, Italy
Lorenza Driul: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
Giovanni Scambia: Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
Giuseppe Vizzielli: Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy

IJERPH, 2022, vol. 19, issue 21, 1-6

Abstract: Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation’s recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium/ovary or endometrioid carcinomas (Müllerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA.

Keywords: mesonephric-like adenocarcinomas; confounding hystology; the importance of diagnosis; case report (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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