子宫内膜异位症是育龄妇女的常见病,定义为子宫体外存在子宫内膜组织(上皮和/或基质)。虽然不是癌前病变,这是一种潜在的恶性肿瘤,尤其是卵巢.值得注意的子宫内膜异位症相关肿瘤包括透明细胞癌和卵巢子宫内膜样腺癌。最近有卵巢中肾样腺癌(MLA)的报道,一种非常罕见的肿瘤,具有与中肾腺癌相似的形态学和免疫表型特征,然而,与中肾残余没有联系。其中一些病例与子宫内膜异位症有关。这里,我们描述了2例直接由子宫内膜异位症引起的MLA。在这两种情况下,有证据表明子宫内膜异位症与肿瘤相邻,其他来源的侵袭被排除.两种肿瘤的免疫表型均为典型的中肾腺癌,但PAX-8呈强烈阳性,提示苗勒氏起源。其中一例的分子检测显示KRAS和P53突变。我们回顾了已发表的MLA和相关子宫内膜异位症的发现。本报告描述了第六和第七例报告的与子宫内膜异位症相关的MLA病例,以及第一例报告的直接由子宫内膜异位症引起并与子宫内膜异位症中其他形式的上皮增殖相关的MLA病例。这2例病例提供了可能的证据,表明MLA应被视为子宫内膜异位症相关肿瘤。
Endometriosis is a common condition in reproductive age women that is defined as the presence of endometrial tissue (epithelial and/or stromal) outside the uterine corpus. While not a premalignant lesion, it is a condition with a potential for malignancy, especially in the ovaries. Notable endometriosis-associated neoplasms include clear cell carcinoma and endometrioid adenocarcinoma of the ovaries. There have been recent reports of mesonephric-like adenocarcinoma (MLA) of the ovary, a very rare neoplasm with similar morphologic and immunophenotypic characteristics as mesonephric adenocarcinoma, however, without an association with mesonephric remnants. Some of these cases have been associated with endometriosis. Here, we describe 2 cases of MLA arising directly from endometriosis. In both cases, there was evidence of endometriosis contiguous with the tumor and invasion from other sources was excluded. The immunophenotypes of both tumors were typical of mesonephric adenocarcinoma except PAX-8 was strongly positive suggesting a Mullerian origin. Molecular testing on one of the cases revealed KRAS and P53 mutations. We
review published findings of MLA and associated endometriosis. This report describes the sixth and seventh reported cases of MLA associated with endometriosis and the first reported cases of MLA arising directly from endometriosis and associated with other forms of epithelial proliferation within endometriosis. These 2 cases provide potential evidence that MLA should be considered an endometriosis-associated neoplasms.