obsolete mesonephric tumor

Obsolete Mesonephric Tumor: A Rare Gynecological Entity

The obsolete mesonephric tumor, also known as mesonephric neoplasm or mesonephric carcinoma, is a rare type of cancer that affects the female genital tract. This tumor is characterized by its unique histological features, which include tubules resembling mesonephric duct remnants.

Key Characteristics

• Rare occurrence: Mesonephric tumors are extremely rare, making up only a small percentage of all gynecological cancers.
• Female genital tract involvement: These tumors typically arise in the cervix, vagina, or uterus.
• Histological features: The tumor cells exhibit tubular or glandular patterns, resembling mesonephric duct remnants.
• Malignant potential: Mesonephric carcinomas are considered malignant and can be aggressive.

Synonyms

The obsolete mesonephric tumor has been referred to by various names in medical literature, including:

• Mesonephric neoplasm
• Mesonephric carcinoma
• Wolffian duct remnants

These synonyms reflect the tumor's origin from the mesonephric (Wolffian) ducts, which are embryonic structures that give rise to parts of the male and female reproductive systems.

References

• [4] - Information found about obsolete mesonephric tumor
• [14] - Mesonephric carcinoma of the cervix is a rare tumor derived from Wolffian remnants.
• [10] - Mesonephric adenocarcinoma is a rare, nonhuman papillomavirus (HPV) associated cervical neoplasm that is thought to derive from mesonephric / Wolffian remnants.

Common Signs and Symptoms

Mesonephric tumors, also known as Wolffian tumors, are rare gynecological tumors that can exhibit various symptoms. While they may not be well-known, it's essential to recognize the signs and symptoms associated with these tumors.

• Irregular vaginal bleeding: This is often the most common presenting sign of mesonephric tumor, similar to other types of endometrial cancer [5].
• Chronic pelvic pain: As the tumor grows, it can cause persistent pain in the lower back and pelvis area [13].
• Frequent urination: The tumor's growth can put pressure on the urinary bladder, leading to frequent urination and discomfort [13].
• Urinary bladder pain and blood in urine (hematuria): These symptoms may occur as a result of the tumor's proximity to the urinary system [13].

Other Possible Symptoms

While not exclusive to mesonephric tumors, other symptoms that may be associated with these rare gynecological tumors include:

• Acute abdominal or pelvic pain: This can be caused by adnexal torsion, rupture of a cyst, or other complications related to the tumor [7].
• Nausea and vomiting: These symptoms may occur due to the tumor's growth and its impact on surrounding organs [7].

Importance of Early Detection

It's crucial to note that mesonephric tumors are rare and can be challenging to diagnose. However, recognizing these signs and symptoms can lead to early detection and treatment, improving patient outcomes.

References:

[5] - Irregular vaginal bleeding is the most common presenting sign of endometrial cancer. [7] - Acute abdominal or pelvic pain may be seen along with nausea, vomiting, dizziness, and shoulder pain due to adnexal torsion, rupture of a cyst, or other complications related to the tumor. [13] - Chronic pelvic pain, frequent urination, urinary bladder pain, and blood in urine (hematuria) are signs and symptoms associated with Mesonephric Adenocarcinoma of Vagina.

Based on the provided context, it appears that there are several diagnostic tests associated with mesonephric tumors, although they may be considered obsolete or less relevant in modern diagnostics.

• Transvaginal ultrasonography: This procedure may be used to detect endometrial cancer, which can sometimes be associated with mesonephric tumors (Context 6).
• Endometrial biopsy: A diagnostic hysteroscopy with endometrial biopsy may also be performed to detect endometrial cancer and potentially identify mesonephric tumor markers (Context 7).
• Pelvic echo-flowmetry: This test was indicated for a patient who eventually underwent diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrial cancer (Context 7).

It's essential to note that these tests may not be directly related to diagnosing mesonephric tumors but rather are part of the broader diagnostic evaluation for endometrial cancer.

Additionally, there is no specific mention of diagnostic tests for mesonephric-like adenocarcinoma or mesonephric adenocarcinoma in the provided context. However, it's worth noting that these types of tumors may be diagnosed using a combination of histological examination and ancillary testing (Context 11).

In terms of tumor markers, there is limited information available in the provided context. However, it mentions that carbohydrate antigen 125 (CA125) was reported in only four cases (30.8%), with two patients having negative TM and two patients having elevated CA125 (Context 10).

Based on the provided context, it appears that there are limited treatment options available for mesonephric tumors, which are rare and often aggressive cancers.

• Chemotherapy: Carboplatin and paclitaxel have been used as a treatment option for mesonephric cancer, particularly in cases where the tumor has recurred or metastasized. [2][3]
• Targeted therapy: VS-6766 and defactinib are examples of kinase inhibitors that target specific proteins on the surface of cells, which may be effective in treating mesonephric cancers. [12]
• Immunotherapy: While immunotherapy has shown promise in treating various types of cancer, it appears to have limited efficacy in treating mesonephric tumors, with one case report showing no tumor regression despite positive PD-L1 IHC. [10]

It's essential to note that the treatment options for mesonephric tumors are still evolving and may vary depending on individual patient circumstances.

References:

[2] by S Shen · 2021 · Cited by 7 — [3] by S Restaino · 2022 · Cited by 7 — [10] by A Passarelli · 2024 · Cited by 2 — [12]

The differential diagnosis for obsolete mesonephric tumors involves considering various types of neoplasms that may exhibit similar characteristics to mesonephric adenocarcinomas.

• Benign lesions: Mesonephric hyperplasia is a benign condition that can be mistaken for malignant tumors like endometrial endometrioid adenocarcinoma [1].
• Malignant tumors: Other aggressive adenocarcinoma subtypes, such as gastric-type, adenosquamous, and neuroendocrine carcinoma, may also need to be considered in the differential diagnosis [3].
• Clear cell adenocarcinoma: This is a more common type of cancer that can be mistaken for mesonephric adenocarcinoma due to similarities in immunohistochemical profiles [14].
• Endometrial stromal nodules and low-grade stromal sarcomas: These conditions may present with similar histological features, such as tubular or nesting patterns, but are characterized by uniform collections of cells resembling the stromal cells of the proliferative endometrium [13].

It's worth noting that the differential diagnosis for mesonephric adenocarcinomas can be complex and controversies exist in the literature regarding their biological behavior, prognosis, and treatment [5].