Xie Chuan, Shen Yang-Mei, Chen Qiu-He, Bian Ce
Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Pathology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2021 Jun 26;9(18):4741-4747. doi: 10.12998/wjcc.v9.i18.4741.
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.
中肾腺癌（MNAC）是女性生殖道极为罕见的恶性肿瘤。文献中仅报道了少数病例，其中大多数发生在宫颈，子宫体和卵巢的病例极为罕见。从未有过MNAC起源于输卵管的报道。
一名45岁女性因腹痛病史转诊至我院。超声检查发现左侧附件区有一囊实性肿块。术中病理检查显示肿块为恶性，患者接受了全面分期手术。最终的组织学和免疫组化结果证实诊断为起源于输卵管的MNAC。随后她接受了四个周期的卡铂联合紫杉醇化疗。初次手术后4个月肿瘤复发并出现肝转移，遂进行了肝脏肿瘤二次切除加部分肝切除术。她又接受了五个疗程的吉西他滨联合卡铂新辅助化疗，二次手术后22个月的随访期内无复发迹象。
起源于输卵管的MNAC极为罕见，恶性程度高，预后差。即使在早期也可能具有很强的侵袭性。对于起源于输卵管的MNAC的临床特征、病理诊断、预后及最佳治疗策略知之甚少。在此我们报道首例原发性起源于输卵管的MNAC病例。
