Metastatic mesonephric adenocarcinoma of unknown origin after hysterectomy: A case report

Müllerian and Wolffian ducts originate from the mesodermal tissue. In females, the Müllerian ducts develop to form the fallopian tubes, uterus, cervix, and upper two-thirds of the vagina; whereas in males, they regress. The Wolffian duct, also called the mesonephric duct, regresses in females during development. Mesonephric carcinomas occur through the female genital tract, and the majority arise in the cervix of the uterus. We report the case of a patient who had abdominal pain 4 weeks prior to admission, and who underwent a hysterectomy 20 years prior. The radiologic results revealed a 6.7 × 5.4 × 4.3 cm-sized mass in the retroperitoneum but were not indicative of mesonephric adenocarcinoma. The patient underwent complete mass surgical resection, followed by posterior sectionectomy of the liver and splenectomy with cholecystectomy. The histopathologic results showed that the mass was a mesonephric adenocarcinoma.

Hysterectomy; Mesonephric adenocarcinoma; Metastatic; Pelvic mass; Unknown origin.

[1] Asano T, Yamamoto M.: ”Mesonephric tumor, mesonephric carci-noma”. Ryoikibetsu shokogun shirizu, 1997, 16, 512-515.

[2] Howitt B.E., Nucci M.R.: “Mesonephric proliferations of the female genital tract”. Pathology (Phila.), 2018, 50, 141-150.

[3] Dierickx A., Göker M., Braems G., Tummers P., Van den Broecke R.: “Mesonephric adenocarcinoma of the cervix: Case report and literature review”. Gynecologic Oncology Reports, 2016, 17, 7-11.

[4] Mueller I., Kametriser G., Jacobs V.R., Bogner G., Staudach A., Koch H., et al.: “Mesonephric adenocarcinoma of the vagina”. Strahlenther. Onkol., 2016, 192, 668-671.

[5] Ferry J.A., Scully R.E.: “Mesonephric Remnants, Hyperplasia, and Neoplasia in the Uterine Cervix”. the American Journal of Surgical Pathology, 1990, 14, 1100-1111.

[6] Montalvo N., Redrobán L., Galarza D.: “Mesonephric adenocar-cinoma of the cervix: a case report with a three-year follow-up, lung metastases, and next-generation sequencing analysis”. Diagn. Pathol., 2019, 14,71.

[7] Yao Y., Han J., Liu C.: ”Mesonephric adenocarcinoma of the vaginal-urethral interspace”. Chin Med J (Engl). 2014, 127, 984-985.

[8] Curry A., Williams T., Penny M.L.: ”Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention”. Am. Fam. Physi-cian, 2019, 100, 357-364.

[9] Li X., Liu T. and Wang L.: “Diagnosis of bladder diverticulum: Retrograde cystography CT more valuable”. Journal of X-Ray Science and Technology, 2015, 23, 481-487.

[10] Gangadhar K., Mahajan A., Sable N., Bhargava P.: “Magnetic Resonance Imaging of Pelvic Masses: A Compartmental Approach”. Seminars in Ultrasound, CT and MRI, 2017, 38, 213-230.

[11] Greenwell T.J., Spilotros M.: “Urethral diverticula in women”. Nature Reviews Urology, 2015, 12, 671-680.

[12] Fankhauser C.D., Mostafid H.: “Prevention of bladder cancer incidence and recurrence”. Curr. Opin. Urol., 2018, 28, 88-92.

[13] Lang G., Dallenbach-Hellweg G.: “The Histogenetic Origin of Cervical Mesonephric Hyperplasia and Mesonephric Adenocarcinoma of the Uterine Cervix Studied with Immunohistochemical Meth-ods”. Int. J. Gynecol. Pathol., 1990, 9, 145-157.

[14] Querleu D., Morrow C.P.: “Classification of radical hysterectomy”. the Lancet Oncology, 2008, 9, 297-303.