Mesonephric-Like Adenocarcinoma of the Endometrium and the Impact of the Updated 2023 FIGO Staging System - Open Access Case Report

Sep 22, 2026

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Mesonephric adenocarcinomas are rare neoplasms derived from remnants of the paired mesonephric ducts, while “mesonephric-like” adenocarcinomas arise in the uterine corpus and mimic true mesonephric tumors morphologically and immunohistochemically. Their diagnosis is pathologically challenging and their behavior is often aggressive, with high rates of recurrence and early lung or liver metastasis. This case report presents an endometrial mesonephric-like adenocarcinoma and evaluates how the updated June 2023 FIGO staging system affects management.

LanguageEnglish

CategoryHealthcare

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Pages5

Reading Time13 min

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ABSTRACT

Introduction

Case Presentation

Final Pathology

Imaging and Treatment

Case Reports in Obstetrics and Gynecology CASE REPORT OPEN ACCESS Mesonephric-Like Adenocarcinoma of the Endometrium and the Impact of the Updated 2023 FIGO Staging System Joy Ogunmuyiwa1, 2 | Alexandra Hamilton1 | Judy Hayek1 | Jocelyn Ogunmuyiwa3 | Constantine Gorelick1 | Daniel Levitan1 | Hani Ashamalla1, 2 1NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, USA | 2NewYork-Presbyterian Weill Cornell Medical Center, New York, USA | 3University of Medicine and Health Sciences, Basseterre, Saint Kitts and Nevis Correspondence: Joy Ogunmuyiwa ([ogunmuyj@mskcc.org](ogunmuyj@mskcc.org)) Received: 30 September 2025 | Revised: 28 January 2026 | Accepted: 6 February 2026 Academic Editor: Gabriel Levin ABSTRACT Mesonephric adenocarcinomas are rare neoplasms derived from remnants of the paired mesonephric ducts. Neoplasms arising from the uterine corpus that are morphologically and immunohistochemically similar to true mesonephric carcinomas, but do not arise from mesonephric remnants, are termed “mesonephric-like” adenocarcinomas. The diagnosis of mesonephric-like adenocarcinoma is pathologically challenging. These tumors often exhibit a mixture of morphologic patterns of more common adenocarcinomas. Although their morphologic, immunohistochemical, and molecular proﬁles have been recently deﬁned, much remains unknown about mesonephric-like adenocarcinomas. A better understanding of mesonephric-like andenocarcinoma’spathogenesis and molecular classiﬁcation is needed to improve diagnosis and guide management of this rare and aggressive subtype of endometrial cancer. An updated International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial carcinoma was introduced in June 2023, upstaging aggressive histological subtypes such as mesonephric-like adenocarcinoma. In this report, we describe a patient with mesonephric-like adenocarcinoma arising in the uterine corpus, highlight the clinical signiﬁcance of 2023 FIGO restaging, and discuss the multidisciplinary approach to treatment. 1 | Introduction Mesonephric ducts, also known as Wolfﬁan ducts, contribute to the development of male reproductive structures in males but are largely vestigial in females [1] . Despite the limited role of mesonephric ducts in females, neoplasms originating from true mesonephric remnants can occur. Mesonephric adenocarcinoma of the endometrium is a rare malignant tumor of the female genital tract comprising less than 1% of all gynecological malignancies [1, 2] . They typically arise in the wall of the uterine cervix or vagina. However, there have been some reported cases in the uterine corpus [3, 4] . Neoplasms arising in the uterine corpus that are morphologically and immunohistochemically similar to true mesonephric carcinomas but do not arise from mesonephric remnants are termed “mesonephric-like” adenocarcinomas [2] . They tend to behave aggressively, with more than half of the published cases presented as an advanced stage (FIGO 2009 Staging≥II) at diagnosis [5] . They also demonstrate an increased risk of recurrence and early metastasis to the lungs and liver [5] . Due to its rarity and overlapping histological features with other uterine tumors, the diagnosis of mesonephric-like adenocarcinoma can pose a challenge. Understanding its unique histopathological characteristics, molecular markers, and clinical implications is crucial for accurate diagnosis, prognostication, and effective management. In this report, we describe a case of This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Copyright © 2026 Joy Ogunmuyiwa et al. Case Reports in Obstetrics and Gynecology published by John Wiley & Sons Ltd. Case Reports in Obstetrics and Gynecology, 2026; 2026:9935815 1 of 5 [https://doi.org/10.1155/crog/9935815](https://doi.org/1

FAQs

What were key immunohistochemical findings used for the presumptive diagnosis?

The tumor glands showed positivity for PAX8, TTF1, GATA3, CK7, and CD10 with a luminal staining pattern. Estrogen receptor was negative, progesterone receptor was <1%, p53 expression was normal (wildtype), p16 was negative, and MMR markers showed an intact (MMR-proficient) phenotype.

Sep 22, 2026

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