Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4741
Peer-review started: October 27, 2020
First decision: January 17, 2021
Revised: April 21, 2021
Accepted: April 29, 2021
Article in press: April 29, 2021
Published online: June 26, 2021
Processing time: 223 Days and 21.6 Hours
Mesonephric adenocarcinoma (MNAC) is an extremely rare malignancy in the female genital tract. Only a few cases have been reported in the literature, and most of them occurred in the cervix, with extremely rare cases in the uterine body and ovary. MNAC has never been reported to arise in the fallopian tube.
A 45-year-old woman was referred to our institution with a history of abdominal pain. Ultrasound revealed a cystic and solid mass in left adnexal region. The patient underwent complete staging surgery when intraoperative pathological examination demonstrated that the mass was malignant. The final histological and immunohistochemical results confirmed the diagnosis of MNAC originating from the fallopian tube. Then she received four cycles of combination chemotherapy with carboplatin plus paclitaxel. The tumor recurred with hepatic metastases 4 mo after initial surgery, and second resection of the tumors in the liver plus partial hepatectomy was performed. She was supplemented with five courses of a new combination chemotherapy with gemcitabine plus carboplatin, and there was no evidence of recurrence within the 22-mo follow-up period after the second surgery.
MNAC originating from the fallopian tube is an extremely rare and high malignancy with a poor prognosis. It can be very aggressive, even at early stage. Little is known about the clinical characteristics, pathological diagnosis, prognosis, and optimal management strategy of MNAC originating from the fallopian tube. Herein we report the first case of primary MNAC deriving from the fallopian tube.
Core Tip: We present the first case of primary mesonephric adenocarcinoma (MNAC) deriving from the fallopian tube without sign of relapse or metastasis after second excision of recurrent lesions until now, which demonstrated a satisfactory response to combination chemotherapy of gemcitabine and carboplatin. MNAC originating from the fallopian tube can be very aggressive, even at early stage. Because of its sensitivity to the chemotherapy regimen, it is reasonable that combination chemotherapy of gemcitabine and carboplatin plays an important role in treatment of recurrent MNAC deriving from the fallopian tube. However, further research is needed to determine the effectiveness of this chemotherapy regimen and provide better therapeutic regimen.