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Case Reports
. 2022 Nov;50(11):E325-E329.
doi: 10.1002/dc.25009. Epub 2022 Jul 2.

An unusual case of carcinoma with mesonephric-like features with a spindle cell component diagnosed on the Pap test of the uterine cervix: Cytomorphologic and immunophenotypic features and diagnostic pitfalls

Sepideh Besharati  1 , Xiaolin Liu-Jarin  1 , Xiaowei Chen  1 , Adela Cimic  1
Affiliations
Case Reports

An unusual case of carcinoma with mesonephric-like features with a spindle cell component diagnosed on the Pap test of the uterine cervix: Cytomorphologic and immunophenotypic features and diagnostic pitfalls

Sepideh Besharati et al. Diagn Cytopathol. 2022 Nov.

Abstract

Mesonephric-like adenocarcinomas (MLA) are rare neoplasms arising in the cervix, endometrium, and ovary. In contrast to mesonephric carcinomas (MC), mesonephric-like adenocarcinomas are not associated with mesonephric remnants. Both entities have a similar appearance with regards to varying histomorphology patterns, including glandular, tubular, spindled, solid, and papillary, and have a specific immunophenotype and molecular features. We present a case of a 54-year-old HPV-negative woman with a Pap test that exhibits high-grade malignancy. The cell block displayed malignant cells with positive stains for PAX8, GATA3, and TTF1 by immunohistochemistry. The diagnosis of adenocarcinoma with mesonephric like features was rendered. MLA can be challenging on the small specimens and often misinterpreted as other endometrial neoplasms. Furthermore, the accurate diagnosis carries a well-described risk of aggressive clinical behavior.

Keywords: Pap test; cervix; cytopathology; endometrial adenocarcinoma; mesonephric-like adenocarcinoma.

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