Akademik Veri Yönetim Sistemi
37. European Congress of Pathology, Vienna, Avusturya, 6 - 10 Eylül 2025, ss.383, (Özet Bildiri)
Heterogeneity in mesonephric adenocarcinoma: clinicopathological and immunohistochemical analysis of two cases
Background & Objectives: Mesonephric carcinomas of the uterine cervix are rare tumours believed to originate from mesonephric remnants. We present two cases of mesonephric adenocarcinoma in patients from different age groups. Methods: First Case: A 40-year-old female patient presented with spotting-type bleeding. Ultrasound revealed no abnormalities in the vagina, cervix, uterus, or adnexa. Pelvic examination identified uterine prolapse and cystocele. The patient underwent cervical amputation due to uterine prolapse, which led to the diagnosis of mesonephric adenocarcinoma. A subsequent total hysterectomy was performed, and no residual tumour was detected. Second Case: A 75-year-old female patient presented with postmenopausal bleeding at an external centre and underwent curettage. Histopathological evaluation of both the initial and repeat curettage samples confirmed the diagnosis of mesonephric adenocarcinoma, leading to a decision for hysterectomy. Results: In the first case, examination of the cervical amputation specimen revealed back-to-back acini lined with low cuboidal cells containing intraluminal eosinophilic secretions, surrounded by desmoplasia. The acini exhibited invasive features within the muscle layer. Immunohistochemically, the tumour cells were positive for GATA-3 and PAX8 but negative for CD10 and the oestrogen receptor. Virchows Archiv 1 3 In the second case, examination of the curettage and hysterectomy specimens showed similar acinar structures, along with papillary formations containing true fibrovascular cores with hierarchical branching, lined by cuboidal/columnar cells. Immunohistochemical analysis demonstrated negativity for the oestrogen receptor, positivity for GATA-3, PAX8, CD10, and TTF-1, wild-type p53 expression, and patchy p16 positivity. In both cases, the invasive appearance of these structures ruled out mesonephric remnants. The combination of oestrogen receptor negativity, wild-type p53 expression, and p16 negativity helped exclude endometrioid-type adenocarcinoma and serous carcinoma. No sarcomatous component was present. Conclusion: Mesonephric adenocarcinoma is a rare cervical tumour that requires both morphological and immunohistochemical differentiation from benign mesonephric remnants and other, more common cervical tumours.