Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics

Kari L Ring¹, Anne M Mills², Brooke E Howitt³, Rachel N Grisham⁴, Elizabeth D Euscher⁵, Hyun-Soo Kim⁶, Ann H Klopp⁷, David L Kolin⁸, W Glenn McCluggage⁹, Jelena Mirkovic¹⁰, Kay J Park¹¹, Eliane Aoun¹², Chika Awujo¹³, Ji Son¹⁴, Samuel C Mok¹⁵, Sammy Ferri-Borgogno¹⁶, David S Hong¹⁷, Lien Hoang¹⁸, Amir A Jazaeri¹⁹, Jeffrey A How²⁰, Karen H Lu²¹

Affiliations

¹ Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: kel7j@uvahealth.org.
² Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: amm7r@virginia.edu.
³ Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: bhowitt@stanford.edu.
⁴ Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, NY, New York, USA. Electronic address: grishamr@mskcc.org.
⁵ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: EDEusche@mdanderson.org.
⁶ Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: hyun-soo.kim@samsung.com.
⁷ Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: AKlopp@mdanderson.org.
⁸ Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: dkolin@bwh.harvard.edu.
⁹ Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK. Electronic address: glenn.mccluggage@belfasttrust.hscni.net.
¹⁰ Department of Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address: jelena.mirkovic@sunnybrook.ca.
¹¹ Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, NY, New York, USA. Electronic address: ParkK@MSKCC.ORG.
¹² Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: EAoun1@mdanderson.org.
¹³ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: CGAwujo@mdanderson.org.
¹⁴ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: JYSon@mdanderson.org.
¹⁵ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: scmok@mdanderson.org.
¹⁶ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: SFerri@mdanderson.org.
¹⁷ Department of Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: dshong@mdanderson.org.
¹⁸ Department of Pathology, Vancouver General Hospital, Vancouver, BC, Canada. Electronic address: Lien.Hoang@vch.ca.
¹⁹ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: AAJazaeri@mdanderson.org.
²⁰ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: JAHow@mdanderson.org.
²¹ Department of Gynecologic Oncology, Moffitt Cancer Center & Research Institute, Tampa, FL, USA. Electronic address: karen.lu@moffitt.org.

PMID: 40279981
DOI: 10.1016/j.ygyno.2025.04.583

Review

Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics

Kari L Ring et al. Gynecol Oncol. 2025 Jun.

. 2025 Jun:197:57-65.

doi: 10.1016/j.ygyno.2025.04.583. Epub 2025 Apr 24.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: kel7j@uvahealth.org.
² Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: amm7r@virginia.edu.
³ Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: bhowitt@stanford.edu.
⁴ Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, NY, New York, USA. Electronic address: grishamr@mskcc.org.
⁵ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: EDEusche@mdanderson.org.
⁶ Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: hyun-soo.kim@samsung.com.
⁷ Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: AKlopp@mdanderson.org.
⁸ Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: dkolin@bwh.harvard.edu.
⁹ Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK. Electronic address: glenn.mccluggage@belfasttrust.hscni.net.
¹⁰ Department of Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address: jelena.mirkovic@sunnybrook.ca.
¹¹ Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, NY, New York, USA. Electronic address: ParkK@MSKCC.ORG.
¹² Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: EAoun1@mdanderson.org.
¹³ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: CGAwujo@mdanderson.org.
¹⁴ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: JYSon@mdanderson.org.
¹⁵ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: scmok@mdanderson.org.
¹⁶ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: SFerri@mdanderson.org.
¹⁷ Department of Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: dshong@mdanderson.org.
¹⁸ Department of Pathology, Vancouver General Hospital, Vancouver, BC, Canada. Electronic address: Lien.Hoang@vch.ca.
¹⁹ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: AAJazaeri@mdanderson.org.
²⁰ Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: JAHow@mdanderson.org.
²¹ Department of Gynecologic Oncology, Moffitt Cancer Center & Research Institute, Tampa, FL, USA. Electronic address: karen.lu@moffitt.org.

PMID: 40279981
DOI: 10.1016/j.ygyno.2025.04.583

Abstract

In 2016, McCluggage and colleagues first defined mesonephric-like adenocarcinoma (MLA) of the uterus and extra-uterine sites. Following this initial description, the World Health Organization officially recognized MLA as a type of uterine and ovarian carcinoma and subsequent studies have further refined the morphologic definition, immunohistochemical profile, molecular underpinnings, and clinical behavior in this rare entity. A consortium of pathologists, gynecologic oncologists, medical oncologists, radiation oncologists, as well as basic science collaborators with expertise in MLA was convened to develop consensus regarding the pathologic diagnosis, and to identify unanswered questions and priority areas for research. Here, we review the current understanding of MLA from a pathologic, molecular, and clinical standpoint.

Keywords: Endometrial cancer; Mesonephric-like adenocarcinoma; Novel therapeutics; Ovarian cancer.

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Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics

Affiliations

Mesonephric-like adenocarcinoma of the female genital tract: Pathologic diagnosis, clinical outcomes, and novel therapeutics

Authors

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Abstract

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