{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:18:45Z","timestamp":1785842325283,"version":"3.56.0"},"reference-count":14,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T00:00:00Z","timestamp":1667520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation\u2019s recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium\/ovary or endometrioid carcinomas (M\u00fcllerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA.<\/jats:p>","DOI":"10.3390\/ijerph192114451","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T09:15:37Z","timestamp":1667553337000},"page":"14451","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Mesonephric-Like Adenocarcinomas a Rare Tumor: The Importance of Diagnosis"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7848-0329","authenticated-orcid":false,"given":"Stefano","family":"Restaino","sequence":"first","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pellecchia","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Tulisso","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pathological Anatomy Section, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Paglietti","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Orsaria","sequence":"additional","affiliation":[{"name":"Institute of Pathological Anatomy, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero \u201cSanta Maria della Misericordia\u201d, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Andreetta","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Poletto","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8257-0618","authenticated-orcid":false,"given":"Martina","family":"Arcieri","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica della","family":"Martina","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Biasioli","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mariuzzi","sequence":"additional","affiliation":[{"name":"Medical Area Department, Institute of Pathological Anatomy, Director School of Specialisation in Pathological Anatomy, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, p.le S.Maria della Misericordia, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Driul","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanit\u00e0 Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy"},{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-2691","authenticated-orcid":false,"given":"Giuseppe","family":"Vizzielli","sequence":"additional","affiliation":[{"name":"Department of Medical Area (DAME), Clinic of Obstretics and Gynecology \u201cSanta Maria della Misericordia\u201d, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/PAS.0000000000001766","article-title":"Extrauterine Mesonephric-like Neoplasms: Expanding the Morphologic Spectrum","volume":"46","author":"Deolet","year":"2022","journal-title":"Am. 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Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.pathol.2017.11.084","article-title":"Mesonephric proliferations of the female genital tract","volume":"50","author":"Howitt","year":"2018","journal-title":"Pathology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13000-019-0830-4","article-title":"Coexistence of endometrial mesonephric-like adenocarcinoma and endometrioid carcinoma suggests a M\u00fcllerian duct lineage: A case report","volume":"14","author":"Yano","year":"2019","journal-title":"Diagn. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Deolet, E., Van Dorpe, J., and Van de Vijver, K. (2021). Mesonephric-like adenocarcinoma of the endometrium: Diagnostic advances to spot this wolf in sheep\u2019s clothing. A review of the literature. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040698"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/PAS.0000000000001612","article-title":"Clinicopathologic Characteristics of Mesonephric Adenocarcinomas and Mesonephric-like Adenocarcinomas in the Gynecologic Tract: A Multi-institutional Study","volume":"45","author":"Pors","year":"2021","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1038\/modpathol.2015.103","article-title":"Targeted genomic profiling reveals recurrent KRAS mutations and gain of chromosome 1q in mesonephric carcinomas of the female genital tract","volume":"28","author":"Mirkovic","year":"2015","journal-title":"Mod. 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Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/PGP.0000000000000444","article-title":"An Ovarian Adenocarcinoma With Combined Low-grade Serous and Mesonephric Morphologies Suggests a M\u00fcllerian Origin for Some Mesonephric Carcinomas","volume":"37","author":"Chapel","year":"2018","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/PGP.0000000000000573","article-title":"Ovarian Combined Low-grade Serous and Mesonephric-like Adenocarcinoma: Further Evidence for A Mullerian Origin of Mesonephric-like Adenocarcinoma","volume":"39","author":"McCluggage","year":"2020","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/PAS.0000000000000958","article-title":"Targeted Genomic Profiling Reveals Recurrent KRAS Mutations in Mesonephric-like Adenocarcinomas of the Female Genital Tract","volume":"42","author":"Mirkovic","year":"2018","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/his.13798","article-title":"Pulmonary metastasis of mesonephric-like adenocarcinoma arising from the uterine body: A striking mimic of follicular thyroid carcinoma","volume":"74","author":"Yamamoto","year":"2019","journal-title":"Histopathology"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/21\/14451\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:10:32Z","timestamp":1760145032000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/21\/14451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,4]]},"references-count":14,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["ijerph192114451"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192114451","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,4]]}}}