ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1681324
This article is part of the Research TopicAdvances in Diagnosis and Treatment of Endometrial CancerView all 8 articles
Cytopathologic features of Mesonephric-like Adenocarcinoma in the endometrium and ovary: Eight Cases and Literature Review
Provisionally accepted
- 1Shanghai Jiao Tong University, Shanghai, China
- 2National Cancer Institute, Misrata, Libya
- 3The University of Texas Southwestern Medical Center, Dallas, United States
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Background: Mesonephric-like adenocarcinoma (MLA) is rare and clinically aggressive. Previous studies have characterized the histologic, immunohistochemical, and molecular features of MLA, however, there is limited information regarding its cytological features. Methods: We performed a single-institution study of 8 MLAs, focusing on cytological features. The study cohort consisted of 8 MLA cases confirmed by histopathology and molecular analysis. Results: The cytology samples collected from cervicovaginal specimens (6 cases) and peritoneal washings (2 cases). Cytologically, both cervicovaginal specimens and peritoneal washings demonstrated tight three-dimensional clusters of epithelial cells with nuclear overlapping, nuclear grooves, and intranuclear cytoplasmic pseudoinclusions. Additional architectural patterns included papillary formations (8/8 cases), discohesive single-cell components (5/8 cases), trabecular arrangements (5/8 cases), rosette-like structures (5/8 cases), and feathering (2/8 cases). The nuclei were round to oval and hyperchromatic to ground-glass in quality. One case showed spindle-shaped nuclei, and four cases exhibited marked anisonucleosis with identifiable mitoses. Hyaline-like globules were present in 3 cases. Notably, two cases demonstrated nuclear feathering, and tumor cell necrosis (tumor diathesis) was observed in two cases. Next-generation sequencing revealed pathogenic KRAS mutations in 4 MLAs and a pathogenic NRAS (p.Q61K) mutation in 1 MLA. Clinically, one patient succumbed to disease one month and another patient experienced a recurrence at 43 months, whereas the remaining patients had no evidence of disease at 3–24 months of follow-up. Conclusions: MLA displays unique cytomorphologic features and accurate identification of MLA on cytology should prompt confirmatory tests to exclude potential morphologic mimics and ensure appropriate diagnosis. Keywords: Cytology, Mesonephric-like adenocarcinoma, Molecular features, Uterus, Ovary
Keywords: cytology, Mesonephric-like adenocarcinoma, Molecular features, Uterus, Ovary
Received: 07 Aug 2025; Accepted: 09 Sep 2025.
Copyright: © 2025 Qin, Lin, Zhou, Juan, Zhang, Zheng, Wang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Feng Zhou, Shanghai Jiao Tong University, Shanghai, China
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