Mesonephric-like adenocarcinoma of the ovary: A rare case report and review of the literature

Abstract

Mesonephric-like adenocarcinoma of the ovary is an exceedingly rare malignant tumor within the reproductive system, accounting for fewer than 1 % of all malignant tumors in women. Originating from remnants of the regressed Wolffian duct during embryonic development, its clinical manifestations are nonspecific, and its rarity often leads to delayed diagnosis, resulting in heightened morbidity and long-term recurrence. We discuss a case of 57-year-old woman with ovarian cysts that were incidentally found in abdominal and pelvic sonography and final diagnosis of mesonephric-like adenocarcinoma with peritoneal involvement and 2014 FIGO stage classification of stage IIIc which is extremely rare stage at presentation in this particular tumor. Diagnosis primarily relies on meticulous physical examination coupled with imaging, complemented by histological analysis and the tracking of diagnostic immunohistochemical markers (positive for TTF1, GATA3, PAX8, and CD10 while conversely negative for ER and PR). This study elucidates the clinical and pathophysiological attributes, diagnostic findings, and treatment strategies through the analysis of a subset of patients diagnosed with mesonephric-like adenocarcinoma in the ovary, followed by a comprehensive literature review.