Mesonephric-like Differentiation of Ovarian Endometrioid and High-grade Serous Carcinomas: Clinicopathological and Molecular Characteristics Distinct from Those of Mesonephric-like Adenocarcinoma

Anticancer Res. 2021 Sep;41(9):4587-4601. doi: 10.21873/anticanres.15272.

Abstract

Background/aim: Ovarian endometrioid carcinoma (EC) and high-grade serous carcinoma (HGSC) may exhibit various growth patterns and mimic mesonephric-like adenocarcinoma (MLA). We investigated the clinicopathological and molecular features of ovarian carcinomas with mesonephric-like differentiation (MLD).

Patients and methods: We analyzed the electronic medical records and pathology slides of two EC-MLD and three HGSC-MLD patients, and conducted immunostaining and targeted sequencing of their samples.

Results: All cases showed architectural diversity, compactly aggregated small tubules and ducts, and eosinophilic intraluminal secretions, indicating the possibility of an ovarian MLA. However, the following histological and immunophenotypical features confirmed the diagnoses of EC-MLD and HGSC-MLD: squamous, tubal, and sertoliform differentiation; serous tubal intraepithelial carcinoma; solid, endometrioid, transitional (SET) feature; solid, transitional, endometrioid, mucinous-like (STEM) feature; diffuse expression of hormone receptors and Wilms tumor 1; mutant p53 immunostaining pattern; and wild-type v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog gene.

Conclusion: A subset of ovarian ECs and HGSCs can display MLD and mimic an MLA. A thorough histological examination combined with ancillary tests is crucial to differentiate between these ovarian neoplastic entities.

Keywords: Ovary; endometrioid carcinoma; high-grade serous carcinoma; mesonephric-like adenocarcinoma; mesonephric-like differentiation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Endometrioid / metabolism
  • Carcinoma, Endometrioid / pathology*
  • Cystadenocarcinoma, Serous / metabolism
  • Cystadenocarcinoma, Serous / pathology*
  • Diagnosis, Differential
  • Electronic Health Records
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology*
  • Proto-Oncogene Proteins p21(ras) / metabolism
  • Retrospective Studies
  • Tumor Suppressor Protein p53 / metabolism
  • WT1 Proteins / metabolism
  • Wolffian Ducts / metabolism
  • Wolffian Ducts / pathology*

Substances

  • Biomarkers, Tumor
  • KRAS protein, human
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • WT1 Proteins
  • WT1 protein, human
  • Proto-Oncogene Proteins p21(ras)