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Mesonephric-like adenocarcinomas of the uterine corpus: report of a case series and review of the literature indicating poor prognosis for this subtype of endometrial adenocarcinoma
- Source :
- Journal of Cancer Research and Clinical Oncology. 146:971-983
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Endometrial mesonephric-like adenocarcinoma (ML-AC) represents a recently recognized subtype of endometrial adenocarcinoma (AC) associated with a subtle immunophenotype with a characteristic KRAS-mutation. Detailed clinico-pathologic analyses and prognostic data on ML-AC are limited. We report a series of four cases with histopathological, immunohistochemical, and molecular analyses. These cases as well as the data of previously published cases were reviewed for clinico-pathologic variables and clinical follow-up information. Forty cases of ML-AC were identified. ML-AC represents about 1% of all endometrial carcinomas. Similar to other types of endometrial AC, vaginal bleeding was the leading presenting symptom, and the mean age was 60.0 years (range 31–91). More than a half of the patients presented with locally advanced disease (≥ FIGO stage II) at time of diagnosis, developed a recurrence or died of the disease within a mean follow-up period of 24.7 months (range 3–144.5 months). The most common site of distant disease was pulmonary involvement. Microscopically, ML-ACs present with mixed morphology and show a co-expression of so-called mesonephric and Mullerian markers, suggesting a Mullerian origin of the tumors. Immunostaining for PD-L1 was negative in all tested cases, using different antibodies against PD-L1. Retained staining for mismatch repair proteins on immunohistochemistry and a POLE-mutation suggest a copy number low phenotype within the molecular classification of endometrial carcinomas. Almost all cases showed a KRAS-mutation at codon 12 (mostly G12V). Uterine ML-AC represents a distinct subtype of invasive endometrial AC, associated with KRAS-mutations and characteristic immunohistochemical findings. Clinically, ML-AC may show an aggressive behavior with a high rate of recurrent disease and a substantial risk for distant metastatic disease, especially to the lungs.
- Subjects :
- 0301 basic medicine
Cancer Research
Pathology
medicine.medical_specialty
Adenocarcinoma
Endometrium
Diagnosis, Differential
Mesonephric duct
03 medical and health sciences
0302 clinical medicine
Immunophenotyping
Humans
Medicine
Vaginal bleeding
Aged
business.industry
Cancer
General Medicine
Middle Aged
Prognosis
medicine.disease
Immunohistochemistry
Endometrial Neoplasms
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
medicine.symptom
business
Carcinoma, Endometrioid
Immunostaining
Subjects
Details
- ISSN :
- 14321335 and 01715216
- Volume :
- 146
- Database :
- OpenAIRE
- Journal :
- Journal of Cancer Research and Clinical Oncology
- Accession number :
- edsair.doi.dedup.....81027cd425a036ab2470d354865c5361