The Clinical Characteristics and Treatment Outcomes of Mesonephric Tumours of the Uterine Cervix - A Systematic Review and Proposal of Embryologically-Oriented Surgical Resection

Sep 21, 2026

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Cervical mesonephric adenocarcinomas (MNACs) are among the rarest female genital tract neoplasms and differ from the predominantly squamous, HPV-associated cervical cancers in histology and underlying biology. This systematic review evaluates current management and clinical outcomes by critically appraising surgical and adjuvant therapies and proposing embryologically oriented resection. A search of MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov (1960–June 2024) identified 49 publications describing 91 MNAC cases. Most patients presented with stage I disease; recurrence and survival metrics indicated clinically aggressive behavior and poor prognosis, supporting tailored treatment strategies for improved oncologic outcomes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages20

Reading Time50 min

AccessFree to download

Abstract

Background/Objectives

Methods

Results

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Introduction

Systematic Review The Clinical Characteristics and Treatment Outcomes of Mesonephric Tumours of the Uterine Cervix: A Systematic Review and Proposal of Embryologically-Oriented Surgical Resection Mohammad Daas 1, Christina Pappa 2,*, Dana Shibli 3, Abdallah Al-Ani 4, Sunanda Dhar 2, Sanjiv Manek 2, Ahmad Sayasneh 5 and Moiad Alazzam 2 Academic Editors: Eyal Sheiner and Erich Cosmi Received: 21 October 2024 Revised: 21 November 2024 Accepted: 23 December 2024 Published: 28 December 2024 Citation: Daas, M.; Pappa, C.; Shibli, D.; Al-Ani, A.; Dhar, S.; Manek, S.; Sayasneh, A.; Alazzam, M. The Clinical Characteristics and Treatment Outcomes of Mesonephric Tumours of the Uterine Cervix: A Systematic Review and Proposal of Embryologically-Oriented Surgical Resection. J. Clin. Med. 2025, 14, 117 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)jcm14010117 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Basildon and Thurrock University Hospital, Basildon SS16 5NL, UK; [mo.daas1996@gmail.com](mo.daas1996@gmail.com) 2 Oxford University Hospitals, NHS Foundation Trust, Oxford OX3 9DU, UK; [sunanda.dhar@ouh.nhs.uk](sunanda.dhar@ouh.nhs.uk) (S.D.); [sanjiv.manek@ouh.nhs.uk](sanjiv.manek@ouh.nhs.uk) (S.M.); [research@gynaefellow.com](research@gynaefellow.com) (M.A.) 3 Jordan University Hospital, Amman 11942, Jordan; [shiblidana76@gmail.com](shiblidana76@gmail.com) 4 King Hussein Cancer Center, Amman 11941, Jordan; [abdallahalany@gmail.com](abdallahalany@gmail.com) 5 Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK; [ahmad.sayasneh@gstt.nhs.uk](ahmad.sayasneh@gstt.nhs.uk) * Correspondence: [christina.pappa@ouh.nhs.uk](christina.pappa@ouh.nhs.uk) Abstract: Background/Objectives: Cervical mesonephric adenocarcinomas (MNACs) are among the rarest neoplasms of the female genital tract. Unlike the majority of cervical cancers, which are predominantly squamous in origin and strongly associated with HPVseropositivity, MNACs are distinct in both histology and pathophysiology. Despite their unique characteristics, MNACs have historically been managed in parallel with squamous cell carcinomas, resulting in a lack of optimised, evidence-based treatment protocols. In this systematic review, we aim to evaluate the current management strategies for MNACsand their associated clinical outcomes. Additionally, we critically appraise existing surgical and adjuvant therapies and propose embryologically oriented surgical techniques to achieve optimal tumour resection. Methods: We performed a systematic search across the MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases from 1960 to June 2024 . The search strategy employed a combination of keywords and MeSH terms, including“Uterine Cervical Neoplasms” [MeSH],“mesonephric tumour”,“mesonephric neoplasm”, and “mesonephric cancer”. All relevant publications, including case reports and case series, were considered. Results: A total of 49 publications were finally included in the analysis, involving a thorough description of 91 MNAC cases. Most patients had stage I disease (70.8%) (n = 51) . Hysterectomy was performed in 77 patients. The median follow-up was 29 months (range 1–199 months) . Disease recurrence was observed in 35.2%(n = 25) of the cases, with the median disease-free survival (DFS) being 24 months (range 1–199) . At the follow-up, 64.8%(n = 46) of patients remained in remission irrespective of the treatment modality, while 27.4%(n = 20) died due to disease progression. Conclusions: Mesonephric neoplasms of the uterine cervix are rare and clinically aggressive cancers that signify poor prognosis. Accurate identification and effective m

FAQs

What makes cervical mesonephric adenocarcinomas (MNACs) distinct from most cervical cancers?

MNACs are rare and differ from the majority of cervical cancers in both histology and pathophysiology. Unlike predominantly squamous cancers strongly linked to HPV, MNACs show distinct biological and microscopic features.

How was the literature search conducted in this systematic review?

The review searched MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov from 1960 to June 2024. It used a combination of keywords and MeSH terms, and included relevant publications such as case reports and case series.

What did the review report about disease stage, recurrence, and remission?

Most patients had stage I disease. Recurrence occurred in 35.2% of cases, and at follow-up 64.8% of patients remained in remission, while 27.4% died due to disease progression.

Sep 21, 2026

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