Mesonephric-like Adenocarcinoma of the Female Genital Tract: A Comprehensive Review of Clinicopathological, Immunophenotypic, Molecular Features, and Clinical Management

Background: Mesonephric adenocarcinoma (MA) is a non-HPV associated tumor originating from mesonephric remnants, predominantly occurring in the uterine cervix. Mesonephric-like adenocarcinoma (MLA) is a recently recognized rare malignancy of the female genital tract. Its histomorphology, immunohistochemistry, and molecular characteristics are similar to those of MA. However, unlike MA, MLA is not associated with mesonephric remnants. Summary: Histologically, MLA can present various patterns including tubule-like, glandular, papillary, solid, sex cord-like, trabecular, retiform, cribriform, glomeruloid, and spindle cell patterns. Immunohistochemically, most MLAs show negative or focal weak positive expression for ER, while being positive for TTF-1, CD10, and GATA3. Molecularly, these tumors often harbor KRAS gene mutations. This article summarizes the research progress on MLA, aiming to enhance the understanding of this tumor type among clinicians and pathologists.