Abstract
Carcinosarcoma of the uterine cervix is less common than its counterpart in the uterine corpus. On the other hand, mesonephric adenocarcinoma is also a rare neoplasm in the uterine cervix, and it has been reported that mesonephric adenocarcinomas are often accompanied by sarcomatous components. We present a case of mesonephric adenocarcinoma with a sarcomatous component which arose in a 63-year-old postmenopausal woman. The hysterectomy specimen grossly showed an exophytic mass measuring 1.8 cm in the uterine cervix. Histologically, diffuse mesonephric hyperplasia and adenocarcinoma with malignant spindle cell proliferation was recognized, and therefore the tumor was diagnosed as “mesonephric adenocarcinoma with a sarcomatous component.” The review of the literature of cervical carcinosarcoma and cervical mesonephric adenocarcinoma revealed that 16% of cervical carcinosarcoma is of mesonephric duct origin, and that mesonephric adenocarcinoma seems to be more likely to have sarcomatous change. We think the presence of a sarcomatous component in the cervical biopsy specimen could be helpful in the diagnosis of mesonephric duct origin.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1243996503911062
Highlights
Carcinosarcoma is the neoplasm composed of malignant epithelial and mesenchymal components, and a mesenchymal component of carcinosarcoma is recently considered as a metaplastic change of carcinoma
We present a case of mesonephric adenocarcinoma with a sarcomatous component arising from mesonephric hyperplasia of the uterine cervix, and comprehensively review the literature of the cervical carcinosarcoma arising from Müllerian ducts and mesonephric ducts
These values may represent an overestimate since these are more likely than the Müllerian variants to be reported in the literature. It seems that mesonephric adenocarcinoma is more likely to have sarcomatous change than the usual uterine cervical carcinoma arising from Müllerian ducts
Summary
Carcinosarcoma is the neoplasm composed of malignant epithelial and mesenchymal components, and a mesenchymal component of carcinosarcoma is recently considered as a metaplastic change of carcinoma. The tumor cells were focally arranged in small nests or glands, resulting in a diagnosis of undifferentiated carcinoma. The hysterectomy specimen grossly showed an exophytic mass in the left lateral wall of the cervix, measuring 1.8 cm (Figure 1). In the adjacent area of mesonephric hyperplasia, adenocarcinoma composed of small irregular glands was observed. Compared to hyperplasia, these irregular glands had severe cytological atypia (Figure 3). Based on these findings, the diagnosis of mesonephric adenocarcinoma with a sarcomatous component arising in mesonephric hyperplasia was confirmed, being staged at pT2a because of minimal invasion of the adenocarcinoma into the vaginal wall
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