Mesonephric adenocarcinomas of the cervix

Adenocarcinoma of mesonephric type is a rare primary tumor of the cervix. Thirteen examples, representing 3% of primary cervical adenocarcinomas in our files, were studied. The neoplasms were commonly polypoid and exophytic and, in 10 instances, were clinically confined to the cervix (Stage I) at time of initial pelvic examination. Microscopically, they were composed of clear and hobnail-type cells arranged in mixtures of papillary, tubular, and solid patterns. Clusters of small tubules resembling mesonephric remnants were identified at the base of the tumor or in the adjacent stroma in 5 cases. These tubules showed varying degrees of atypicality and merged with infiltrating adenocarcinoma in 3 instances, indicating that some cervical adenocarcinomas of this histologic type do arise from mesonephric remnants. Although an associated in-situ carcinoma was not found, origin from cervical epithelium is also likely for some examples. No single explanation for the histogenesis is sufficient, inasmuch as identical neoplasms arise from different tissues in the endometrium, ovary, and vagina. The actuarial survival was 55% at 5 years and 40% at 10 years. The number of cases compiled so far is inadequate to determine the best mode of therapy for this lesion.