Mesonephric-like adenocarcinoma of the endometrium: A rare case report and review of the literature

Tóm tắt

Mesonephric-like adenocarcinoma (MLA) of the endometrium is a rare subtype of endometrial carcinoma, accounting for approximately 1% of all endometrial cancers. In the 4th edition of the WHO classification (2014), only “mesonephric carcinoma – MC” of the uterine cervix was recognized, whereas mesonephric-like tumors of the endometrium or ovary were not considered as a separate entity. Following multiple studies describing tumors with morphologic and immunophenotypic features similar to MC but arising from the endometrium or ovary, the 5th edition of the WHO classification (2020) officially designated the term “mesonephric-like adenocarcinoma” to distinguish this entity. MLA exhibits a characteristic immunohistochemical profile, typically showing positivity for GATA-3, CD10, TTF-1 and negativity for ER, PR. A wide spectrum of histologic patterns may be present within the same tumor, which can lead to misdiagnosis as low-grade endometrioid adenocarcinoma, clear cell carcinoma, serous carcinoma, or even carcinosarcoma. Moreover, this type of tumor was reported to be associated with poorer outcome compared to Müllerian-type carcinomas; therefore, an accurate diagnosis is of paramount importance. This article aims to present the first case of MLA in Vietnam in a 62-year-old woman presenting with postmenopausal abnormal bleeding, and to review the literature. We discuss the histopathological, immunoprofile and molecular characteristics, along with differential diagnosis and prognosis, to provide further diagnostic insight for pathologists.