Mesonephric Adenocarcinoma of the Uterine Cervix: A Rare Entity Not to be overlooked

Mesonephric adenocarcinoma is a rare malignant tumor which derives from mesonephric embry¬onic remnants of wolffian ducts of the female genital tract. We describe a case of 59-year-old postmenopausal lady presenting with an abnormal vaginal bleeding misdiagnosed initially as undifferentiated papillary carcinoma. Imaging revealed a thickening in cervix of the uterus associated with pulmonary and peritoneal nodules. Histological features were consistent with mesonephric adenocarcinoma. Moreover, the tumor cells showed positive staining for CD10, GATA3 and E-cadherin, while progesterone receptor (PR) and estrogen receptor (ER) expressions were completely negative. For the locally advanced disease with multiple metastases, the patient underwent systemic chemotherapy as part of the therapeutic approach. Awareness of this rare tumor and its large admixture of morphologic patterns supported by immunoreactivity for mesonephric carcinoma markers, is crucial to prevent diagnostic errors, facilitate early therapeutic intervention and potentially improve prognosis.