TY - JOUR
T1 - Mesonephric-Like Adenocarcinomas a Rare Tumor: The Importance of Diagnosis
AU - Restaino, Stefano
AU - Pellecchia, Giulia
AU - Tulisso, Angelica
AU - Paglietti, Chiara
AU - Orsaria, Maria
AU - Andreetta, Claudia
AU - Poletto, Elena
AU - Arcieri, Martina
AU - Martina, Monica Della
AU - Biasioli, Anna
AU - Mariuzzi, Laura
AU - Driul, Lorenza
AU - Scambia, Giovanni
AU - Vizzielli, Giuseppe
PY - 2022
Y1 - 2022
N2 - Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation's recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium/ovary or endometrioid carcinomas (Mullerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA.
AB - Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation's recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium/ovary or endometrioid carcinomas (Mullerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA.
KW - case report
KW - the importance of diagnosis
KW - mesonephric-like adenocarcinomas
KW - confounding hystology
KW - case report
KW - the importance of diagnosis
KW - mesonephric-like adenocarcinomas
KW - confounding hystology
UR - http://hdl.handle.net/10807/233434
U2 - 10.3390/ijerph192114451
DO - 10.3390/ijerph192114451
M3 - Article
SN - 1660-4601
VL - 19
SP - 1
EP - 6
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
ER -