Dedifferentiated Mesonephric-like Adenocarcinoma of the Uterine Corpus
Dedifferentiated Mesonephric-like Adenocarcinoma of the Uterine Corpus
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DOI：
10.21873/anticanres.15053
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发表时间：
2021-05-01
影响因子：
2
通讯作者：
Kim, Hyun-Soo
中科院分区：
文献类型：
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作者：
Choi, Sangjoon;Na, Kiyong;Kim, Hyun-Soo
背景/目的：我们介绍一例子宫去分化中肾样腺癌（MLA）。病例报告：一名 54 岁女性因子宫肿块在子宫肉瘤的印象下接受了全子宫切除术。在组织学上，MLA 表现出多种生长模式，包括管状和腺体结构。未分化癌（UC）显示出不粘连的肿瘤细胞，没有任何明显的结构。免疫组织化学显示，UC 在极少数分散的肿瘤细胞中呈上皮标记阳性。 MLA 表现出野生型 p53 表达模式，而 UC 表现出均匀且强烈的 p53 免疫反应性。靶向测序分析揭示了两种成分中相同的克尔斯滕大鼠肉瘤病毒癌基因同源物（KRAS）突变。在 UC 中检测到致病性错义肿瘤蛋白 53 (TP53) 突变，但在 MLA 中未检测到。结论：仅在 UC 中检测到的突变 p53 表达模式与错义 TP53 突变的存在一致。我们的观察表明 TP53 突变与从 MLA 到 UC 的可能转变有关。
Background/Aim: We present a case of uterine dedifferentiated mesonephric-like adenocarcinoma (MLA). Case Report: A 54-year-old woman underwent total hysterectomy for a uterine mass under the impression of a uterine sarcoma. Histologically, MLA exhibited various growth patterns including tubular and glandular architecture. Undifferentiated carcinoma (UC) displayed discohesive tumor cells without any obvious architecture. Immunohistochemically, UC was positive for epithelial markers in very few scattered tumor cells. MLA exhibited the wild-type p53 expression pattern, whereas UC showed a uniform and strong p53 immunoreactivity. Targeted sequencing analysis revealed an identical Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in both components. A pathogenic missense tumor protein 53 (TP53) mutation was detected in UC, but not in MLA. Conclusion: The mutant p53 expression pattern exclusively detected in UC was concordant with the presence of missense TP53 mutation. Our observations suggested that TP53 mutation is associated with the possible transformation from MLA to UC.