2023 Volume 73 Issue 2 Pages 37-44
Abstract : In this case report, we present a rare case of mesonephric adenocarcinoma of the cervix that recurred with pulmonary metastases six years after initial treatment. At first presentation, the patient was a 69-year-old woman, gravida 3 para 2. She presented to a clinic with a chief complaint of lower back pain. She was referred to our hospital because she had an enlarged uterus, cervical cytology showed no abnormalities and endometrial cytology was positive. Transvaginal ultrasound revealed a substantial cervical mass measuring 4 cm, and a biopsy from this site suggested mesonephric adenocarcinoma. A radical hysterectomy and bilateral adnexectomy were performed, and histopathology confirmed the presence of mesonephric adenocarcinoma with extension from the cervix to the vaginal wall and invasion of the right parametrium. The final clinical stage was stage IIB mesonephric adenocarcinoma of the cervix, and concurrent chemoradiotherapy was given as adjuvant therapy. Six years after surgery for cervical cancer, lesions in the left lung field and elevated CA19-9 were observed. Partial resection of the upper lobe of the left lung revealed a recurrence of mesonephric adenocarcinoma. 18 months later, an enlarged mass was found in the right lung field and a diagnosis of recurrent mesonephric adenocarcinoma was made. After three courses of CPT-11 chemotherapy, the mass in the right lung field shrank and the patient is currently alive with a performance status of 0, 108 months after surgery for cervical cancer. Mesonephric adenocarcinoma of the cervix is a rare and challenging disease to diagnose preoperatively due to its embryological features. The presence of a solid lesion on the cervix, even in the absence of abnormal cervical cytology, should raise suspicion for this disease. Long-term follow-up is crucial as recurrence can occur several years after surgery.
