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Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics

Mesonephric-like adenocarcinoma (MLA) arising in the ovary is a rare malignant tumor of the female genital tract. Although the clinicopathological and molecular characteristics of uterine MLA have been accumulated, those of ovarian MLA have not been firmly clarified. In this study, we investigated t...

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Autores principales: Koh, Hyun Hee, Park, Eunhyang, Kim, Hyun-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871294/
https://www.ncbi.nlm.nih.gov/pubmed/35204416
http://dx.doi.org/10.3390/diagnostics12020326
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author Koh, Hyun Hee
Park, Eunhyang
Kim, Hyun-Soo
author_facet Koh, Hyun Hee
Park, Eunhyang
Kim, Hyun-Soo
author_sort Koh, Hyun Hee
collection PubMed
description Mesonephric-like adenocarcinoma (MLA) arising in the ovary is a rare malignant tumor of the female genital tract. Although the clinicopathological and molecular characteristics of uterine MLA have been accumulated, those of ovarian MLA have not been firmly clarified. In this study, we investigated the clinicopathological, immunohistochemical, and genetic features of five ovarian MLAs. A review of electronic medical records and pathology slides, immunostaining, and targeted sequencing was performed. On imaging, ovarian MLA presented as either a mixed solid and cystic mass or a purely solid mass. One, three, and one patient were diagnosed as having FIGO stage IA, IC, and II MLA, respectively. Four patients with stage IC–II tumor underwent post-operative adjuvant chemotherapy. Three of the four patients whose follow-up information was available did not experience recurrence. In contrast, the remaining patient with stage IA tumor who did not receive any adjuvant treatment developed multiple metastatic recurrences at post-operative 13 months. Histologically, ovarian MLAs characteristically displayed architectural diversity, compactly aggregated small tubules, and eosinophilic intraluminal secretions. Four tumors were found to be associated with endometriotic cysts. Two cases showed some areas of high-grade nuclear atypia, brisk mitotic activity, and necrosis. Immunohistochemically, all cases showed positive immunoreactivities for at least three of the four examined mesonephric markers (GATA3, PAX2, TTF1, and CD10), lack of WT1 expression, non-diffuse p16 immunoreactivity, and wild-type p53 immunostaining pattern. Targeted sequencing analysis revealed that all four examined cases harbored pathogenic KRAS mutations: p.G12V (2/4); p.G12D (1/4); and p.G12C (1/4). In addition, we reviewed the previous literature reporting 60 cases of ovarian MLA. Our findings corroborate those of the previous data regarding the clinical presentation, histological features, immunophenotypes, and molecular alterations. Our observations should encourage pathologists to recognize and accurately diagnose this rare but distinct entity.
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spelling pubmed-88712942022-02-25 Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics Koh, Hyun Hee Park, Eunhyang Kim, Hyun-Soo Diagnostics (Basel) Article Mesonephric-like adenocarcinoma (MLA) arising in the ovary is a rare malignant tumor of the female genital tract. Although the clinicopathological and molecular characteristics of uterine MLA have been accumulated, those of ovarian MLA have not been firmly clarified. In this study, we investigated the clinicopathological, immunohistochemical, and genetic features of five ovarian MLAs. A review of electronic medical records and pathology slides, immunostaining, and targeted sequencing was performed. On imaging, ovarian MLA presented as either a mixed solid and cystic mass or a purely solid mass. One, three, and one patient were diagnosed as having FIGO stage IA, IC, and II MLA, respectively. Four patients with stage IC–II tumor underwent post-operative adjuvant chemotherapy. Three of the four patients whose follow-up information was available did not experience recurrence. In contrast, the remaining patient with stage IA tumor who did not receive any adjuvant treatment developed multiple metastatic recurrences at post-operative 13 months. Histologically, ovarian MLAs characteristically displayed architectural diversity, compactly aggregated small tubules, and eosinophilic intraluminal secretions. Four tumors were found to be associated with endometriotic cysts. Two cases showed some areas of high-grade nuclear atypia, brisk mitotic activity, and necrosis. Immunohistochemically, all cases showed positive immunoreactivities for at least three of the four examined mesonephric markers (GATA3, PAX2, TTF1, and CD10), lack of WT1 expression, non-diffuse p16 immunoreactivity, and wild-type p53 immunostaining pattern. Targeted sequencing analysis revealed that all four examined cases harbored pathogenic KRAS mutations: p.G12V (2/4); p.G12D (1/4); and p.G12C (1/4). In addition, we reviewed the previous literature reporting 60 cases of ovarian MLA. Our findings corroborate those of the previous data regarding the clinical presentation, histological features, immunophenotypes, and molecular alterations. Our observations should encourage pathologists to recognize and accurately diagnose this rare but distinct entity. MDPI 2022-01-27 /pmc/articles/PMC8871294/ /pubmed/35204416 http://dx.doi.org/10.3390/diagnostics12020326 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Koh, Hyun Hee
Park, Eunhyang
Kim, Hyun-Soo
Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title_full Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title_fullStr Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title_full_unstemmed Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title_short Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
title_sort mesonephric-like adenocarcinoma of the ovary: clinicopathological and molecular characteristics
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871294/
https://www.ncbi.nlm.nih.gov/pubmed/35204416
http://dx.doi.org/10.3390/diagnostics12020326
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