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Mesonephric Adenocarcinoma of the Uterine Cervix Associated with Florid Mesonephric Hyperplasia: A Case Report.

Abdul-Ghafar J, Chong Y, Han HD, Cha DS, Eom M - J Lifestyle Med (2013)

Bottom Line: The cervix was slightly enlarged eccentrically, without a definite mass-like lesion.The Ki-67 proliferation index was slightly increased.The patient received routine adjuvant treatment and was alive and clinically free of disease at two-year follow-up.

View Article: PubMed Central - PubMed

Affiliation: Departments of Pathology. Yonsei University Wonju College of Medicine, Wonju, Korea.

ABSTRACT
Hyperplasia and neoplasia of mesonephric remnants in the uterine cervix are uncommon conditions that are often mis-diagnosed as usual forms of cervical adenocarcinoma. Here, we report a case of mesonephric adenocarcinoma with florid mesonephric hyperplasia of the uterine cervix in a 48-year-old female patient. The cervix was slightly enlarged eccentrically, without a definite mass-like lesion. Microscopically, the tumor cells infiltrated the cervical stroma with focal myometrial extension and were composed of predominantly round to polygonal cells arranged in ductal, tubular, or cystic structures. The remaining stroma revealed diffuse and florid mesonephric hyperplasia intertwined with tumor cells. Immunohistochemically, the tumor cells were positive for pancytokeratin, epithelial membrane antigen, and CD10. The Ki-67 proliferation index was slightly increased. The patient received routine adjuvant treatment and was alive and clinically free of disease at two-year follow-up.

No MeSH data available.


Related in: MedlinePlus

Immunohistochemical findings show positive reaction in the tumor cells for (A) epithelial membrane antigen (EMA) and (B) CD10 and negative reaction for (C) CEA. (D) The Ki-67 proliferation index was slightly increased.
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f2-jlm-03-117: Immunohistochemical findings show positive reaction in the tumor cells for (A) epithelial membrane antigen (EMA) and (B) CD10 and negative reaction for (C) CEA. (D) The Ki-67 proliferation index was slightly increased.

Mentions: A 48-year-old, gravid 4, para 2 woman was admitted to our hospital due to change in size of a known uterine mass. The result of a cervical Papanicolau smear examination was normal. Physical examination revealed a slightly enlarged uterus with multiple masses and normal vagina and uterine cervix. On the routine laboratory check up, the serum levels of carcinoembryonic antigen (CEA) and CA19-9 were within the normal ranges, and there was a mild increase in CA125 level (44.6 U/ml). Vaginal hysterectomy was performed for an initial diagnosis of uterine adenomyosis. Grossly, the entire cervix was eccentrically slightly enlarged, 3.5 × 2.5 × 2.5 cm in size without a definite mass-like lesion. The myometrium had a diffuse nodular appearance with multiple scattered bloody punctuations. Microscopically, the tumor cells infiltrated the entire cervical stroma with focal myometrial extension (Fig. 1A). The tumor was predominantly composed of round to polygonal cells arranged in ductal, tubular, or cystic structures and had round to oval hyper-chromatic large nuclei, small nucleoli, and small amounts of cytoplasm (Fig. 1B). The remaining cervical stroma revealed diffuse and florid mesonephric hyperplasia intermingled with tumor cells. The myometrium showed focal extension of tumor with diffuse adenomyosis. The immunohistochemical findings showed positive reactions in the tumor cells for pancytokeratin (CK), epithelial membrane antigen (EMA), and CD10 and negative reactions for CEA, inhibin, estrogen receptor (ER), and progesterone receptor (PR). The Ki-67 proliferation index was slightly increased (Fig. 2). A summary of the present case with regard to immunohistochemical studies as compared with previous reported cases in the literature is given in Table 1. The patient received six cycles of adjuvant chemotherapy and radiotherapy. There was no evidence of lymph node involvement, metastatic disease, or recurrence during a two-year follow-up period.


Mesonephric Adenocarcinoma of the Uterine Cervix Associated with Florid Mesonephric Hyperplasia: A Case Report.

Abdul-Ghafar J, Chong Y, Han HD, Cha DS, Eom M - J Lifestyle Med (2013)

Immunohistochemical findings show positive reaction in the tumor cells for (A) epithelial membrane antigen (EMA) and (B) CD10 and negative reaction for (C) CEA. (D) The Ki-67 proliferation index was slightly increased.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4390743&req=5

f2-jlm-03-117: Immunohistochemical findings show positive reaction in the tumor cells for (A) epithelial membrane antigen (EMA) and (B) CD10 and negative reaction for (C) CEA. (D) The Ki-67 proliferation index was slightly increased.
Mentions: A 48-year-old, gravid 4, para 2 woman was admitted to our hospital due to change in size of a known uterine mass. The result of a cervical Papanicolau smear examination was normal. Physical examination revealed a slightly enlarged uterus with multiple masses and normal vagina and uterine cervix. On the routine laboratory check up, the serum levels of carcinoembryonic antigen (CEA) and CA19-9 were within the normal ranges, and there was a mild increase in CA125 level (44.6 U/ml). Vaginal hysterectomy was performed for an initial diagnosis of uterine adenomyosis. Grossly, the entire cervix was eccentrically slightly enlarged, 3.5 × 2.5 × 2.5 cm in size without a definite mass-like lesion. The myometrium had a diffuse nodular appearance with multiple scattered bloody punctuations. Microscopically, the tumor cells infiltrated the entire cervical stroma with focal myometrial extension (Fig. 1A). The tumor was predominantly composed of round to polygonal cells arranged in ductal, tubular, or cystic structures and had round to oval hyper-chromatic large nuclei, small nucleoli, and small amounts of cytoplasm (Fig. 1B). The remaining cervical stroma revealed diffuse and florid mesonephric hyperplasia intermingled with tumor cells. The myometrium showed focal extension of tumor with diffuse adenomyosis. The immunohistochemical findings showed positive reactions in the tumor cells for pancytokeratin (CK), epithelial membrane antigen (EMA), and CD10 and negative reactions for CEA, inhibin, estrogen receptor (ER), and progesterone receptor (PR). The Ki-67 proliferation index was slightly increased (Fig. 2). A summary of the present case with regard to immunohistochemical studies as compared with previous reported cases in the literature is given in Table 1. The patient received six cycles of adjuvant chemotherapy and radiotherapy. There was no evidence of lymph node involvement, metastatic disease, or recurrence during a two-year follow-up period.

Bottom Line: The cervix was slightly enlarged eccentrically, without a definite mass-like lesion.The Ki-67 proliferation index was slightly increased.The patient received routine adjuvant treatment and was alive and clinically free of disease at two-year follow-up.

View Article: PubMed Central - PubMed

Affiliation: Departments of Pathology. Yonsei University Wonju College of Medicine, Wonju, Korea.

ABSTRACT
Hyperplasia and neoplasia of mesonephric remnants in the uterine cervix are uncommon conditions that are often mis-diagnosed as usual forms of cervical adenocarcinoma. Here, we report a case of mesonephric adenocarcinoma with florid mesonephric hyperplasia of the uterine cervix in a 48-year-old female patient. The cervix was slightly enlarged eccentrically, without a definite mass-like lesion. Microscopically, the tumor cells infiltrated the cervical stroma with focal myometrial extension and were composed of predominantly round to polygonal cells arranged in ductal, tubular, or cystic structures. The remaining stroma revealed diffuse and florid mesonephric hyperplasia intertwined with tumor cells. Immunohistochemically, the tumor cells were positive for pancytokeratin, epithelial membrane antigen, and CD10. The Ki-67 proliferation index was slightly increased. The patient received routine adjuvant treatment and was alive and clinically free of disease at two-year follow-up.

No MeSH data available.


Related in: MedlinePlus