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.

UNASSIGNED: Mesonephric-like adenocarcinoma (MLA) is a rare malignant gynecologic neoplasm occurring in the uterine corpus and ovary. The morphological and immunohistochemical characteristics of MLA closely resemble that of cervical mesonephric adenocarcinomas, but whether they share a common histogenesis remains unclear. Two main theories for histogenesis of MLAs include the origination of these neoplasms from mesonephric remnants, as is the case for cervical mesonephric adenocarcinoma, versus the differentiation along a mesonephric pathway from Mullerian lesions.
UNASSIGNED: A 67-year-old presented after a right salpingo-oophorectomy for a complex ovarian mass revealed a mesonephric-like adenocarcinoma of the ovary and endometriosis. She underwent a total abdominal hysterectomy, pelvic lymphadenectomy, and infra-colic omentectomy, and diagnosed with Stage IA mesonephric-like adenocarcinoma of the ovary. At 18 months post-operatively, the patient developed flank and abdominal pain and was found to have multiple sites of recurrent disease. She was referred to medical oncology for chemotherapy as she was not a candidate for surgical cytoreduction.
UNASSIGNED: This case demonstrates the aggressive nature of ovarian MLA and the need for a multidisciplinary approach when determining the treatment. In addition, this case provides further evidence to support the theory that at least a subset of MLAs arises from a Mullerian lesion which then differentiates down a mesonephric pathway.

Aorta-gonad-mesonephros (AGM) is well known as a main structure that de novo generates hematopoietic primary stem cells (HSC) in mid-gestation mammalian embryos. Hemogenic endothelium, and recently, subendothelial mesenchyme as well as hemangioblast are shown as contributing to blood formation in AGM region. AGM-HSC displays dynamic changes in surface markers, including CD41, CD45 and several endothelial-specific molecules. The novel finding of interleukin-3 as a potent regulator of AGM-HSC seems very interesting. Moreover, zebra fish model reveals PGE2 as a novel stimulator of HSC in AGM and kidney marrow, which is also the case in mouse hematopoietic tissues. Identification of mesenchymal stem cells with significant hematopoietic supporting capacity in AGM region suggests an alternative pathway to explore new molecules governing embryonic and adult hematopoiesis. In this paper, the hemogenic model in AGM region, surface markers on HSCs in AGM region and regulation of HSCs in AGM region were reviewed.

During mammalian ontogeny, hematopoietic activity can be found in distinct anatomical sites, which con-tribute to primitive or definite hematopoiesis. The origin of the hematopoietic stem cell (HSC) has been a controversial issue in the field of hematopoiesis. It has long been believed that the origin derives from the extra-embryonic yolk sac. However, there is now considerable evidence that the first adult repopulating HSC is autonomously generated from a distinct region within the embryonic mesoderm, the aorta-gonad-mesonephros (AGM) region. This review describes the origin and precise location of HSC in the embryo and in AGM region, the hematopoietic microenvironment and the hematopoietic regulatory mechanisms in AGM region.

We report a case of bilateral persistence of the common mesonephric duct in a child. This anomaly is an error of implantation of the vas deferens in the distal part of the Wolffian duct. This abnormality is extremely rare (6 cases have been reported in the world literature). The diagnosis is usually incidental during laparotomy or on retrograde cystography (vesico-ureteric and vesico-deferential reflux). It is simple to treat: bilateral deferential ligation in view of the context of multiple malformations, in order to prevent ascending genital infections (prostatitis, epididymitis, testicular abscess). Only one case has been reported in adults, presenting in the form of a septic complication. This diagnosis must be considered in a context of atypical urogenital infection in a subject with other congenital abnormalities.

Eight cases of adenomatoid tumors of the male genital tract are presented. Histological, histochemical, and electron microscopic studies were performed and an approach to a new classification of adenomatoid tumors was discussed. The number of so-called adenomatoid tumors of male genital tract reported in Japan adding our eight cases totalled 60 cases. These were classified as follows; 10 cases of mesothelial (superficial) type and 50 cases of adenomatoid (profound) type. Besides these, 8 cases of mesothelial type were reported in foreign literatures. Three cases of adenomatoid tumors of the uterus and a case of epididymitis chronica with reactive proliferation of mesothelial cells were also examined. As a result of these investigations, it is suggested that the histogenesis of the so-called adenomatoid tumors is composed of two different processes; i.e., mesothelial type arising from serosal mesothelial cells. and adenomatoid type arising from immature Müllerian mesenchymal tissue.

The rete ovarii is the homologue of the rete testis. It develops from cells of mesonephric origin which immigrate into the developing gonad of the embryo. The mature form of the rete ovarii is generally found to be groups of anastomosing tubules lined by cuboidal or columnar epithelium. These tubules are usually located in the hilus of the ovary, but may extend through the medulla or be isolated in the mesovarium adjacent to the hilus. The rete is often continuous with the transverse ductules through which it contacts the longitudinal duct of the epoophoron. The rete ovarii is important in the control of meiosis in the maturing ovary. Cells of the rete ovarii differentiate to form granulosa cells as well. The rete is also credited with secretory capability, a hypothesis supported by the observation of secretory material in the lumina of the rete tubules in several species. Cysts have been observed in the rete ovarii of several species. The rete ovarii of the adult does not appear to be a functionless vestige as has been previously reported.

A rare case of florid mesonephric hyperplasia (FMH) of the cervix found incidentally in the hysterectomy specimen of a 49-year-old woman was studied with light and electron microscopy as well as histochemistry and immunohistochemistry. A lack of architectural and cytologic atypia of the glands and tubules and a benign clinical course are consistent with a hyperplastic rather than neoplastic process. Direct histologic continuity between mesonephric duct remnants and hyperplastic glands with numerous cytotelolysosomes and lack of intracellular mucin and carcinoembryonic antigen are the features that distinguish FMH from minimal deviation adenocarcinoma of the endocervix.

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A case of an extrarenal Wilms tumor arising in the inguinal region of a 2-month-old boy is described. A review of the literature indicates that nine well-documented cases of extrarenal Wilms tumor have previously been described. Four of these tumors arose within teratomas. The remaining five cases, in which no teratomatous components were encountered, probably arose in embryologic rests of renal tissue.