Ovarian Mesonephric-Like Adenocarcinoma With Recurrent Liver Metastases: A Case Report with Analysis of Therapeutic Molecular Targets

Ayumi Sugitani, Sugitani A, Ayako Ogawa, Ogawa A, Hiroshi Yoshida, Mayumi Kobayashi-Kato, Kobayashi-Kato M, Kikkawa N, Nao Kikkawa, Tanase Y, Yasuhito Tanase, Masaya Uno, Uno M, Mitsuya Ishikawa, Ishikawa M, Kato T, Tomoyasu Kato
International journal of surgical pathology · 2024 · vol. 32(3) , pp. 578–585 · doi:10.1177/10668969231183631 · PMID:37345348
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This case report details an ovarian mesonephric-like adenocarcinoma with rapid liver metastases, analyzing its molecular markers to identify potential therapeutic targets.

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This paper is a case report of ovarian mesonephric-like adenocarcinoma with recurrent liver metastases, including an analysis of molecular therapeutic targets relevant to the tumor. The authors describe target expression for druggable biomarkers, focusing on antibody-drug conjugate targets TROP2, CLDN6, B7-H3, and DLL3, to inform what molecular vulnerabilities were present in this patient’s disease. The key limitation is that the findings are based on a single case, so therapeutic target analysis cannot establish generalizable efficacy or broader prevalence. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Ovarian mesonephric-like adenocarcinoma (MLA) is a rare cancer subtype. We describe a patient with ovarian MLA wherein liver metastases developed 1 month after surgery. A phenotypic analysis of the tumor was performed to identify molecular therapeutic targets. A 53-year-old woman, without any symptoms, underwent uterine cancer screening. Transvaginal ultrasonography revealed an ovarian mass, and subsequent pelvic magnetic resonance imaging showed a 13 × 10 cm multicystic ovarian lesion with a solid part. No extra ovarian lesions were observed and a staging laparotomy was performed. Pathological examination revealed an MLA of the left ovary (stage IC1). The tumor comprised tumor cells in a tubular pattern with intraluminal eosinophilic material, as well as mixed glandular and papillary, cord-like, and solid patterns. Endometriosis was also observed. Immunohistochemically, the tumor cells were positive for PAX8, GATA3 (focal), TTF1 (focal), and CD10 (luminal) and negative for the estrogen receptor, progesterone receptor, and WT1. One month after surgery, computed tomography revealed multiple liver metastases. Additional immunohistochemistry for therapeutic targets revealed that the tumor cells were weakly positive for human epidermal growth factor receptor 2 (focal; score 1+), pan-tropomyosin receptor kinase-negative, programmed death-ligand 1-negative, and PMS2 and MSH6 intact. The companion homologous recombination deficiency test (MyChoice®) showed homologous recombination repair proficiency. These findings suggest that poly(ADP-ribose) polymerase inhibitors and immune checkpoint inhibitors may not be effective treatment options. A literature review revealed that data on therapeutic targets in MLA are scarce. In summary, we report a patient with ovarian MLA showing an aggressive clinical course and the phenotypic analysis of the tumor may contribute to the identification of therapeutic targets for MLA.
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Data availability statement Authors Author Contributions Correction (July 2023): Metrics and citations Metrics Journals metrics This article was published in International Journal of Surgical Pathology. View All Journal MetricsPublication usage* Total views and downloads: 321 *Publication usage tracking started in December 2016 Publications citing this one Receive email alerts when this publication is cited Web of Science: 5 view articles Opens in new tab Crossref: 7 - Expression of the antibody-drug conjugate targets TROP2, CLDN6, B7-H3, and DLL3 in mesonephric-like adenocarcinoma of the female genital tract - Mesonephric-like Adenocarcinoma (MLA) Diagnostic Criteria and Controversies: Perspectives and Guidance From Pathologists in the MLA Consortium - Two Cases of Mesonephric-Like Adenocarcinoma Arising From Ovary and Peritoneal and Literature Review - Diagnostic Imaging Characteristics of a Rare Primary Ovarian Mesonephric-Like Adenocarcinoma: A Case Report and Literature Review - Rare malignant ovarian tumors: a review - Transabdominal Combined with Transvaginal Ultrasound in the Diagnosis of Ovarian Mesonephric-Like Adenocarcinoma: One Case Report and Analysis of Clinicopathological Features and Imaging Findings - Ovarian Mesonephric-like Adenocarcinoma: Its Prevalence in a Japanese High-Volume Cancer Center and a Literature Review on Therapeutic Targets Figures and tables Figures & Media Tables View Options Access options If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below: loading institutional access options Alternatively, view purchase options below: Purchase 24 hour online access to view and download content. Access journal content via a DeepDyve subscription or find out more about this option.

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endometriosis

MeSH descriptors

Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma

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