Mesonephric-like adenocarcinoma of the ovary with co-existent endometriosis: A case report and review of the literature

Mesonephric-like adenocarcinoma of the ovary with co-existent endometriosis: A case report and review of the literature

Blog Article

Introduction: Mesonephric-like adenocarcinoma (MLA) is a rare malignant gynecologic neoplasm occurring in the uterine corpus and ovary.The morphological and immunohistochemical characteristics of MLA closely resemble that of cervical mesonephric adenocarcinomas, but whether they share a common histogenesis remains unclear.Two main theories for histogenesis of MLAs include the origination of these neoplasms from mesonephric remnants, Pre-Rolls as is the case for cervical mesonephric adenocarcinoma, versus the differentiation along a mesonephric pathway from Mullerian lesions.Case: A 67-year-old presented after a right salpingo-oophorectomy for a complex ovarian mass revealed a mesonephric-like adenocarcinoma of the ovary and endometriosis.

She underwent a total abdominal hysterectomy, pelvic lymphadenectomy, and infra-colic omentectomy, and diagnosed with Stage IA mesonephric-like adenocarcinoma of the ovary.At 18 months post-operatively, the patient developed flank and abdominal pain and was found to have multiple sites of recurrent disease.She was referred to medical oncology for chemotherapy as she was not a candidate for surgical cytoreduction.Discussion: This case demonstrates the aggressive nature of ovarian MLA and the need for a multidisciplinary approach when determining the treatment.

In addition, this Fat Separators case provides further evidence to support the theory that at least a subset of MLAs arises from a Mullerian lesion which then differentiates down a mesonephric pathway.