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Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>We report an unexpected case of mesonephric-like adenocarcinoma initially treated as a diffuse adenomyosis in a patient presenting with primary infertility. The aim of this report is to raise clinical awareness about the risk of a diagnostic pitfall where an unexpected malignancy can mimic diffuse adenomyosis. The patient\u2019s main concerns and important clinical findings: A 41-year-old patient referred to a tertiary minimally invasive gynecological center in June 2023 for primary infertility, heavy menstrual bleeding, and a 5 x 6\u00a0cm myometrial mass diagnosed as diffuse adenomyosis on ultrasound scan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>The primary diagnoses, interventions, and outcomes<\/jats:title>\n                    <jats:p>\n                      An open cytoreductive resection of adenomyosis with uterine cavity reconstruction was planned due to worsening abnormal uterine bleeding and two failed\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization attempts. An unexpected Mesonephric-like adenocarcinoma with only small foci of healthy tissue was identified on histopathological examination, and immunohistochemical staining. Consequently, the patient had a total abdominal hysterectomy with bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy. This was followed by six cycles of paclitaxel and carboplatin plus pembrolizumab-based immunotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the importance of thorough evaluation of all atypical myometrial lesions, including adenomyosis, where pre-conception surgical excision and histopathological evaluation are often deferred in most patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1828586","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:40:26Z","timestamp":1780638026000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mesonephric-like adenocarcinoma as an unexpected histological result after fertility saving procedure for presumed adenomyosis: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Vojt\u011bch","family":"Lukavec","sequence":"first","affiliation":[{"name":"Center for Minimally Invasive Gynecologic Surgery, Department of Gynecology, Obstetrics and Neonatology, General University Hospital in Prague and the 1 Medical Faculty of the Charles University","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Fr\u00fchauf","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Gynecologic Surgery, Department of Gynecology, Obstetrics and Neonatology, General University Hospital in Prague and the 1 Medical Faculty of the Charles University","place":["Prague, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdenka","family":"Lisa","sequence":"additional","affiliation":[{"name":"Center for Minimally Invasive Gynecologic Surgery, Department of Gynecology, Obstetrics and Neonatology, General University Hospital in 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