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Research Article |

Mesonephric-Like Adenocarcinoma of the Endometrium Mimicking Advanced Tubo-Ovarian Cancer - A Literature Review Based on a Special Case

Mesonephric-like adenocarcinoma of the endometrium (ML-AC) is a rare variant of endometrial adenocarcinoma with aggressive clinical behavior and unusual metastatic spread. Because of its rarity, the diagnosis may be challenging but needs to be accurate due to the mostly poor prognostic outcome of these tumors. To aid in the understanding and recognition of this entity we present the detailed histopathological, immunohistochemical and molecular analysis of a case of ML-AC clinically mimicking advanced ovarian cancer in a 55-year-old woman and put it in the context of literature research on ovarian and endometrial carcinomas. In the present case the patient revealed abdominal distension, ascites and a moderately elevated CA-125 level (504.8 U/ml) with widespread peritoneal carcinomatosis and an endometrial lesion confined to the endometrium with the presence of free-floating tumor cells within the tubal lumen, suggesting transtubal peritoneal spread of the endometrial primary. All tumor sites shared various architectural patterns on histology with negative staining for p16, WT-1 and estrogen receptor and positivity for TTF-1. Matched pair molecular analysis revealed an identic clonal KRAS-mutation (p.G12C) within the endometrial, peritoneal and lymph node involvement as well as in the recurrent tumor. There was retained mismatch repair protein staining and p53 wild type pattern without any additional mutational alterations, including POLE. A hepatic recurrence was diagnosed after 11 months. Literature study confirms our findings and the suggestion of a morphomolecular diagnostic approach additional to the fact that KRAS-mutation may represent a targetable alteration within a specialized therapeutic approach for this entity.

Endometrium, Cancer, Mesonephric, Adenocarcinoma, TTF-1, Prognosis, KRAS-Mutation, Ovarian

APA Style

Hiller, G. G. R., Höhn, A. K., Krücken, I., Hagert-Winkler, A., Martin, M., et al. (2023). Mesonephric-Like Adenocarcinoma of the Endometrium Mimicking Advanced Tubo-Ovarian Cancer - A Literature Review Based on a Special Case. Cancer Research Journal, 11(4), 127-135.

ACS Style

Hiller, G. G. R.; Höhn, A. K.; Krücken, I.; Hagert-Winkler, A.; Martin, M., et al. Mesonephric-Like Adenocarcinoma of the Endometrium Mimicking Advanced Tubo-Ovarian Cancer - A Literature Review Based on a Special Case. Cancer Res. J. 2023, 11(4), 127-135. doi: 10.11648/j.crj.20231104.12

AMA Style

Hiller GGR, Höhn AK, Krücken I, Hagert-Winkler A, Martin M, et al. Mesonephric-Like Adenocarcinoma of the Endometrium Mimicking Advanced Tubo-Ovarian Cancer - A Literature Review Based on a Special Case. Cancer Res J. 2023;11(4):127-135. doi: 10.11648/j.crj.20231104.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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