Peritoneal Mesonephric-Like Adenocarcinoma Arising in Endometriosis: Case Report and Review of the Literature Expanding the Spectrum of Extrauterine Mesonephric-Like Adenocarcinomas.
Khaled Sabry Mohamed, Kareem Elfatairy, Jennifer Crow et al.
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Case in brief
A 55-year-old woman with a history of endometriosis presented with peritoneal mesonephric-like adenocarcinoma (MLA) infiltrating the bowel wall, along with nodal and hepatic metastases. The tumor exhibited diverse architectural patterns and moderate cytologic atypia. Immunohistochemical analysis revealed positivity for keratin, PAX8, and TTF-1, while molecular testing identified a KRAS p.G12V mutation. The case highlights the importance of accurate diagnosis in this rare malignancy.
What made this case unusual
The association of peritoneal MLA with endometriosis is particularly noteworthy, as it expands the understanding of potential origins for this rare carcinoma.
Diagnostic / clinical pearl
Pathologists should include mesonephric-like adenocarcinoma in the differential diagnosis of peritoneal tumors, especially those linked to endometriosis, to avoid misclassification.
Why it matters
This case underscores the diagnostic challenges posed by mesonephric-like adenocarcinomas and the need for a comprehensive approach to their identification.