Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Anticancer Res. 2021 May;41(5):2719-2726. doi: 10.21873/anticanres.15053.
BACKGROUND/AIM: We present a case of uterine dedifferentiated mesonephric-like adenocarcinoma (MLA).
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.
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.
背景/目的：我们报告了一例子宫去分化中肾样腺癌（MLA）病例。
一名 54 岁女性因子宫肿块接受了全子宫切除术，术前印象为子宫肉瘤。组织学上，MLA 表现出多种生长模式，包括管状和腺状结构。未分化癌（UC）显示出离散的肿瘤细胞，没有任何明显的结构。免疫组化显示，上皮标志物在极少数散在的肿瘤细胞中呈阳性。MLA 表现出野生型 p53 表达模式，而 UC 则显示均匀且强烈的 p53 免疫反应性。靶向测序分析显示两种成分均存在相同的 Kirsten 大鼠肉瘤病毒致癌基因同源物（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。
仅在 UC 中检测到的突变型 p53 表达模式与错义 TP53 突变的存在一致。我们的观察结果表明，TP53 突变与 MLA 向 UC 的可能转化有关。
