Mesonephric Adenocarcinoma of the Uterine Cervix: An Update of the Immunohistochemical Profile.
Mohammad Othman, Elizabeth Euscher, Anais Malpica. MD Anderson Cancer Center, Houston, Tx
Background: Mesonephric adenocarcinoma (MA) is a rare subtype of uterine cervical carcinoma (CA).Secondary to overlapping histologic features with other subtypes of cervical CA (endometrioid and clear cell carcinoma), proper recognition can be challenging.Immunohistochemistry (IHC) is frequently utilized to assist with proper classification.It has been suggested that the use of PAX-2 may distinguish benign and mesonephric cervical lesions from cervical CA on the basis that PAX-2 was lost in usual type cervical CA.This study evaluates the expression of PAX-8 and PAX-2 as well as other traditional IHC in a series of MA.In situ hybridization (ISH) for high risk HPV is also evaluated.
Design: Six cases of MA were retrieved from our institutional files spanning 1991-2008. Pathology material was reviewed in all cases to confirm diagnosis.All cases were investigated by IHC for PAX2, PAX8, and p16. ISH for high risk HPV was performed on all cases.Previously performed IHC was also reviewed as part of the study.Clinical information was obtained from patients' (pts) charts.
Results: Pts ages ranged from 41-57 years (median 46).The most common presenting symptoms included: vaginal bleeding, 4 cases; menorrhagia, 1 case; and cervical polyp, 1 case. Five pts underwent hysterectomy; in cases where the stage was known (n=4), all were stage 1.Follow up ranging from 12 to 60 mos was available in 5 pts.All are currently free of disease.The immunoperoxidase results are summarized in table 1.