Cervical mesonephric adenocarcinoma: A case report of a rare gynecological tumor from embryological remains of the female genital tract / Adenocarcinoma mesonéfrico cervical: Relato de caso de um tumor ginecológico raro de restos embriológicos do trato genital feminino

Abstract Introduction Malignant mesonephric tumors are uncommon in the female genital tract, and they are usually located where embryonic remnants of Wolffian ducts are detected, such as the uterine cervix. The information about these tumors, their treatment protocol, and prognosis are scarce. Case report A 60-year-old woman with postmenopausal vaginal bleeding was initially diagnosed with endometrial carcinoma. After suspicion co-testing, the patient underwent a loop electrosurgical excision of the cervix and was eventually diagnosed with mesonephric adenocarcinoma. She was subjected to a radical hysterectomy, which revealed International Federation of Gynecology and Obstetrics (FIGO) IB1 stage, and adjuvant radiotherapy. The follow-up showed no evidence of recurrence after 60 months. Conclusion We present the case of a woman with cervical mesonephric adenocarcinoma. When compared with the literature, this case had the longest clinical follow-up without evidence of recurrence, which reinforces the concept that these tumors are associated with a favorable prognosis if managed according to the guidelines defined for the treatment of patients with cervical adenocarcinomas. Though a rare entity, it should be kept in mind as a differential diagnosis for other cervical cancers.

Cervical Mesonephric Adenocarcinoma: A Case Report of a Rare Gynecological Tumor from Embryological Remains of the Female Genital Tract.

INTRODUCTION: Malignant mesonephric tumors are uncommon in the female genital tract, and they are usually located where embryonic remnants of Wolffian ducts are detected, such as the uterine cervix. The information about these tumors, their treatment protocol, and prognosis are scarce. CASE REPORT: A 60-year-old woman with postmenopausal vaginal bleeding was initially diagnosed with endometrial carcinoma. After suspicion co-testing, the patient underwent a loop electrosurgical excision of the cervix and was eventually diagnosed with mesonephric adenocarcinoma. She was subjected to a radical hysterectomy, which revealed International Federation of Gynecology and Obstetrics (FIGO) IB1 stage, and adjuvant radiotherapy. The follow-up showed no evidence of recurrence after 60 months. CONCLUSION: We present the case of a woman with cervical mesonephric adenocarcinoma. When compared with the literature, this case had the longest clinical follow-up without evidence of recurrence, which reinforces the concept that these tumors are associated with a favorable prognosis if managed according to the guidelines defined for the treatment of patients with cervical adenocarcinomas. Though a rare entity, it should be kept in mind as a differential diagnosis for other cervical cancers.

Female adnexal tumours of probable Wolffian origin: an immunohistochemical study comparing tumours, mesonephric remnants and paramesonephric derivatives.

AIMS: To establish an immunohistochemical profile of presumed female adnexal mesonephric tumours (FATWO) for diagnostic purposes and to compare the findings with those of mesonephric and paramesonephric derivatives in order to establish supportive evidence for a mesonephric origin. METHODS AND RESULTS: Standard immunohistochemistry was performed on formalin-fixed tissues. Tumours, mesonephric remnants and paramesonephric structures generally show positive staining for vimentin, CAM 5.2 and cytokeratins 7 and 19 but are negative for CK20 and 34 beta E12. EMA is positive in both mesonephric and paramesonephric derivatives but is negative in the tumours. Glutathione S-transferase mu (GST mu) is generally positive in both tumours and mesonephric derivatives but negative in paramesonephric structures. CONCLUSIONS: Immunohistochemistry plays little part in the diagnosis of FATWO. The tumours are generally cytokeratin and vimentin-positive and EMA-negative. GST mu, as a marker for the mesonephric duct, is a useful adjunct. Our findings of the study support but do not prove that FATWOs are of mesonephric origin.

[The role of embryoid bodies in the development of germinogenous tumors of complex structure and of the teratoma]. / Rol' émbrioidnykh telets v razvitii germinogennykh opukholei slozhnogo stroeniia i teratomy.

250 germinal gonadal and extragonadal tumors were studied in children and adolescents under 16 years of age. Germinal tumours of complex structure were found in 42 patients and in 36 of them embryoid bodies of various types (full, not-full, amorphous) were distinguished. Certain features were revealed indicating the development of the immature teratoma by means of maturation of preexisting embryoid bodies. The arguments in favour of complex germinal tumour development due to the loss of maturation and differentiation capacity of one or several structural elements of the embryoid bodies are presented. The observation of mature, immature embryonal tissues and proliferating elements of the embryoid bodies in the composition of one and the same tumour may be explained by different biological potency of individual clones of atypical and primordial germinal cells which are the source of the development of these tumours.

Retroperitoneal embryonal carcinoma/yolk sac tumor. A case report and a review of the histogenesis.

A case of 26-year old man, with a large primary retroperitoneal tumor which showed the pattern of embryonal carcinoma as well as yolk sac tumor, is reported. The disease ran an aggressive course and led to death within 8 months from the onset of clinical symptoms. Characteristic histological and ultrastructural patterns with Schiller-Duval bodies and adenocarcinomatous differentiation were accompanied by diffuse expression of alpha-fetoprotein and human chorionic gonadotropin expression in isolated cells, as well. The histogenesis of the tumor may be interpreted in terms of the reflection of the very early stages of the embryonal development rather than by the totipotent-neoplastic-germ-cell approach.

Mesonephric adenocarcinoma of bladder.

Mesonephric adenocarcinoma of the bladder is an extremely rare neoplasm. The typical location in the bladder neck and trigone tends to confirm that this neoplasm probably derives from a remanent of the mesonephric duct. This case is the fourth described in the literature. The patient underwent total cystectomy with ureterosigmoidostomy and is still apparently tumor free 7 years after operation.

Studies on the histogenesis of experimentally induced yolk sac tumor in rats.

As a method to elucidate the histogenesis of this tumor, it is necessary to make a comparative study of the morphological relation between the histopathology of the tumor and the mother tissue which is considered to be the origin of the tumor. Therefore, as already reported, since we induced the yolk sac tumor by treating the fetal membrane of pregnant rats with carcinogenic agents, we have comparatively studied the tumor tissue and the fetal membrane, which is considered the mother tissue, to elucidate the histogenesis by seeking the similarity between them and the common features and obtained the following conclusions. First, the presence of PAS positive non-glycogenic granules was noted in both cytoplasms, and then the localization of AFP was confirmed in both cytoplasms also in the study with a fluorescence antibody method using anti-rat AFP antibody. Further, in the observation at the level of electron microscopy, as findings common to both, we noted the presence of round homogeneous non-structural substance and characteristically developed r-ER, and, on the other hand, immature nuclei containing thread-like nucleolonema, considered characteristic to germ cell tumor. From the above results, this induced tumor was considered to have developed from the rat fetal membrane as mother tissue.

Paravaginal wolffian duct (mesonephros) adenocarcinoma: a light and electron microscopic study.

This is a report of an adenocarcinoma of mesonephric origin studied by light microscopy, electron microscopy, and immunocytochemistry. Unlike previous reports, our lesion was located paravaginally and not in the leaves of the broad ligament or in the cervix. The light microscopic features are similar to those of previous cases in the literature. Although not specific, the ultrastructural features of the tumor are similar to those of mesonephric structures and different from those of müllerian structures. The diagnosis always should be considered when a tumor occurs at the site where mesonephric remnants may be found and after exclusion of a carcinoma of other pelvic organs or a metastasis from a primary neoplasm elsewhere.

[Yolk sac tumor by fetectomy in the rat: histopathological characteristics and histogenesis (author's transl)].

Experimentally induced yolk sac tumors in rats were investigated with special regard to morphological and histochemical characteristics. Pregnant rats whose fetuses were removed on the 12th day of gestation, developed tumors which were derived from fetal membranes left outside the uterus. Out of 119 operated rats which had been mated with syngenic males, 95 rats beared tumors, which were histologically yolk sac tumors (46 cases), adenocarcinomas (29 cases), choriocarcinomas (5 cases) and teratomas (69 cases). An early lesion of yolk sac tumor was observed as early as 3 weeks after the surgical procedure, and the sera from these tumor-bearing rats were positive for alpha-fetoprotein (AFP). Morphological features of both the induced tumors and the cultured tumor cell masses revealed a thick stroma consisting of a PAS-positive basement membrane-like material, which closely resembled Reichert's membrane of the parietal yolk sac in the normal placenta. The intracellular localization of AFP in cultured cells was investigated by immuno-electron microscopic method, and the reaction product for AFP was seen in the endoplasmic reticulum and Golgi complex. Histogenesis of the tumor is also discussed.

Mesonephric adenocarcinoma of bladder.

Mesonephric adenocarcinoma of the bladder is an unusual tumor, with its origin unclear. Metaplasia of urothelium and anaplasia of embryonic cell rests appear to be the cause of this tumor. A patient is described with mesonephric adenocarcinoma, who is now apparently free of disease two years after a radical cystectomy and ileal conduit. This represents the second such report in the literature.