Adnexal Tumor Of Wolffian Origin Research Articles

Lésions de type mésonéphrique des organes génitaux féminins : un panorama depuis les tumeurs bénignes jusqu’aux aux entités malignes émergentes

Mesonephric lesions in the female genital tract are uncommon and heterogeneous. Those deriving from the upper tract differ from those developing in the lower tract, based on their morphology and immunohistochemical profile. Carcinomas of mullerian origine may display the morphology, the immunoprofile and even the molecular abnormalities of those deriving from mesonephric remnants and are designated mesonephric-like carcinomas. These are high-grade lesions despite their well-differentiated glandular morphology (wolf in sheep's clothing). New entities, such as STK11 adnexal tumors, have merged recently and should not be confused with adnexal tumors of wolffian origin (FATWO), which have a better prognostic and outcome. In this review, we provide an overview of these lesions and their mimickers, in order to help pathologists in the diagnostic approach of these complex and rare neoplasms.

The complex and often confusing history, histology and histogenesis of mesonephric, STK11 adnexal tumour and mesonephric-like neoplasms of the upper female genital tract (including broad ligament).

Mesonephric lesions in the female genital tract are uncommon, with those arising from the upper tract being much less frequent than those developing in the lower tract (mesonephric hyperplasia and carcinoma). The most common upper tract lesions include rete cyst/cystadenoma and female adnexal tumour of Wolffian origin (FATWO). The integration of morphological, immunohistochemical and molecular studies on FATWOs has enabled recognition of a novel entity, the STK11 adnexal tumour, which is often associated with Peutz-Jeghers syndrome (~50%) and frequently has a salivary gland morphology but an unknown origin. Similarly, 'mesonephric-like' adenocarcinoma, an entity with striking similarities to mesonephric carcinoma but currently favoured to be of Müllerian derivation based on its association with other Müllerian tumours and molecular findings, has also been recently described, and may histologically mimic both FATWOs and STK11 adnexal tumours. In this review, we provide a historical overview of upper female genital tract mesonephric proliferations and discuss mesonephric lesions, STK11 adnexal tumour, mesonephric-like adenocarcinoma, and mimickers, the most common being endometrioid carcinoma.

Female Adnexal Tumor of Wolffian Origin Presenting as Paratubal / Broad Ligament Masses: A Case Report

Introduction: A female adnexal tumor of probable Wolffian origin (FATWO) is a rare type of gynecological tumor that is difficult to diagnose based on laboratory and radiologic studies. Although FATWO is considered a benign tumor, recurrence and metastasis have been reported. Currently, there is no best surgical and surveillance approach for FATWO. We presented two Wolffian tumors as paratubal / broad ligament masses. Case Presentation: This is a report of a 32-year-old woman with vaginal discharge and incidentally pelvic mass diagnosis who underwent conservative surgery with a frozen section based on the Wolffian duct tumor. Immunohistochemically, the results confirmed FATWO. The patient was free of recurrence 20 months after conservative surgery. Conclusions: Although FATWO has benign behavior, some types of this tumor have malignant features, and there is no clear recommendation regarding optimal treatment and surveillance of FATWO. Therefore, based on the literature, pathologists are recommended to utilize a wide array of immunohistochemical stainings to offer appropriate diagnosis and optimal surgery to patients. Moreover, patients should be followed up for a long-term period until we have enough knowledge in the field.

Female Adnexal Tumour of Wolffian Origin: A Rare Case Report

Female Adnexal Tumour of Wolffian Origin (FATWO) is a rare tumour occurring in adnexal region, arising from the remnants of the mesonephric duct, in places like the broad ligament, fallopian tube, ovarian hilum, peritoneum. Here the authors have reported a case of FATWO in a 47-year-old woman occurring in the wall of fallopian tube and confirmed with immunohistochemistry. Most of these tumours behave in a benign fashion but certain histological features like hypercellularity, cellular pleomorphism and nuclear atypia cause significant confusion in histopathological diagnosis. Multiple differential diagnoses were considered. After careful histopathological examination and thorough investigation with multiple immunohistochemical stains, the diagnosis was ultimately established.

Female Adnexal Tumour of Wolffian Origin Masquerading as a Broad Ligament Fibroid: A Rare Case Report

Female adnexal tumour of Wolffian origin (FATWO), a rare neoplasm arising from the female adnexa, is typically benign in nature, although recurrences and metastasis have been reported infrequently. First identified and reported in the early 1970s, less than 100 cases have been reported thus far. We present a case of a 16-year-old girl with a left adnexal tumour of Wolffian origin who presented with excessive bleeding during mensuration. With no overt clinical signs, ultrasound revealed a left ovarian neoplasm which was confirmed by CT scan as a solid enhancing lesion in the left adnexa measuring 6.2 x 5 x 4.5 cm. A broad ligament mass was excised, and cytology of peritoneal fluid wash revealed no malignancy. Histomorphological examination and immunohistochemistry confirmed the diagnosis of FATWO. The postoperative course was uneventful; however, the patient was lost to follow-up. Due to the rarity of occurrence, asymptomatic presentation, its variable location, and its morphological diversity, the diagnosis of FATWO may present a challenge especially when the tumour arises in an ovarian location.

C-KIT Analysis and Targeted Molecular Sequencing of Mesonephric Carcinomas of the Female Genital Tract.

Mesonephric carcinoma is a rare malignancy, thought to derive from Wolffian remnants. To date, no targeted molecular therapeutic options have been identified. On the basis of limited case reports, c-KIT immunohistochemical expression has been reported in female adnexal tumors of Wolffian origin, and targeted therapy with Imatinib has been attempted with mixed success. Currently, it is unclear whether c-KIT immunohistochemical expression is seen in mesonephric carcinoma, a tumor that is thought to be related to female adnexal tumors of Wolffian origin, and how this correlates with KIT mutational status. In this study, we assessed the immunohistochemical expression of c-KIT and KIT mutational status, in a series of 13 mesonephric neoplasms (5 cervical [including 2 cervical carcinosarcomas], 3 uterine corpora, 4 ovarian, and 1 vaginal/pelvic). The intensity of staining and proportion of cells showing cytoplasmic/membranous staining for c-KIT were recorded. KIT was sequenced using a next-generation sequencing panel that targeted 120 hotspots and 17 exons in 33 known actionable cancer genes. This panel included KIT exons 9, 11, and 13, and 6 hotspots (T670, D816, D820, N822, Y823, A829). Although c-KIT immunohistochemical expression was observed in the majority of mesonephric carcinomas (10/12 cases; 83%), no KIT mutations were detected. This cautions pathologists against the use of c-KIT immunohistochemistry as a surrogate marker for KIT-activating mutations in this setting. Consistent with previous studies, the majority of mesonephric neoplasms (10/13; 77%) harbored KRAS mutations. Additional mutations were found in CTNNB1 (2/13, 15%), TP53 (2/13, 15%), and PIK3CA (1/13, 8%).

Malignant female adnexal tumor of Wolffian origin (FATWO)

Malignant female adnexal tumor of Wolffian origin (FATWO)

Female adnexal tumor of Wolffian origin: Case report of a rare tumor

Female adnexal tumor of Wolffian origin (FATWO) is a rare, poorly understood lesion characterized by variety of epithelial patterns and is known to occur in the broad ligament, mesosalpinx, fallopian tube, ovary, and pelvic peritoneum. About 80 cases of FATWO have been reported till date. A 70-year-old posthysterectomized woman reported with lump abdomen. She was provisionally diagnosed as malignant ovarian tumor. The patient was taken up for staging laparotomy. A solid mass arising from the left adnexa was removed along with the right-sided salpingo-oophorectomy and pelvic lymphadenectomy. Histopathological report was “benign Wolffian adnexal tumor.” FATWOs are rare tumors arising from the remnants of the mesonephric duct. Although most of them are benign, some have the potential for malignant behavior. Diagnosis is often based on exclusion of other neoplasms. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are considered the recommended mode of therapy. The role of adjuvant radiation therapy or chemotherapy remains debatable.

Male adnexal tumour of wolffian origin: The first report of metastatic disease

The first case of a male adnexal tumour of probable wolffian duct origin to develop metastatic disease is reported. The characteristic histological appearance and immunohistochemical profiles of the primary and metastatic male tumours are discussed. The scanty experience relating to metastatic disease makes decisions about the most appropriate treatment challenging.

Paravaginal Female Adnexal Tumor of Probable Wolffian Origin

Female adnexal tumor of wolffian origin (FATPWO) is a lesion that predominantly occurs in the broad ligament. Its occurrence in the right paravaginal area is rare; only one other case has been reported to occur at this site. The authors report a case of paravaginal FATPWO in a 20-year-old woman that recurred twice during a 5-year period. The microscopic and ultrastructural features of this lesion were identical to other cases of FATPWO reported in the literature. This tumor must be recognized, especially at this site, so that it is not confused with vaginal adenocarcinoma related to diethylstilbestrol exposure in utero.