Ovarian Mesonephric-like Adenocarcinoma: Its Prevalence in a Japanese High-Volume Cancer Center and a Literature Review on Therapeutic Targets

• Published in: Current oncology (Toronto) Vol. 31; no. 9; pp. 5107 - 5120
• Main Authors: Ogawa, Ayako, Yoshida, Hiroshi, Kawano, Saria, Kikkawa, Nao, Kobayashi-Kato, Mayumi, Tanase, Yasuhito, Uno, Masaya, Ishikawa, Mitsuya
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.08.2024; MDPI
• Subjects: Adenocarcinoma; Adenocarcinoma - pathology; Aged; East Asian People; Female; Health aspects; homologous recombination repair; Humans; immunohistochemistry; Japan - epidemiology; mesonephric-like adenocarcinoma; Metastasis; Middle Aged; Ovarian Neoplasms - genetics; Ovarian Neoplasms - pathology; ovary; Prevalence; Retrospective Studies; therapeutic target; Japan; mesonephric-like adenocarcinoma; ovary; therapeutic target; immunohistochemistry; homologous recombination repair
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol31090378

Ovarian mesonephric-like adenocarcinoma (MLA) is a newly described histological type known for its aggressive behavior. This study aims to determine the frequency of ovarian MLA, review the existing literature, and elucidate its clinicopathological characteristics, including the potential therapeutic targets. We retrospectively reviewed the pathological diagnoses of 501 primary ovarian cancer surgical cases at our institution from 2010 to 2023. MLAs exhibiting typical morphological and immunohistochemical features were included. The frequency and clinicopathological characteristics of these cases were summarized. Additionally, we conducted a literature search using PubMed to collect and summarize previously reported cases of ovarian MLAs. Among the 501 primary ovarian cancer cases, we identified 3 cases (0.6%) of MLA. The patients were 52-76 years old, and the initial FIGO stages were IC1 (two cases) and IIIB (one case). All the cases exhibited HRP, pMMR, PD-L1 negativity (CPS < 1), and low HER2 expression. Two cases experienced metastatic recurrence. A literature review identified 97 cases of MLA. The MLAs frequently exhibited mutations (90%, 38/42), with a recurrence rate of 39% (26/67). MLAs accounted for 0.6% of malignant ovarian tumors at our institution, all of which were advanced or recurrent cases. These cases showed HRP, pMMR, and PD-L1 negativity, indicating a lack of current therapeutic targets. The literature also reported a high incidence of advanced and recurrent cases, highlighting the need for accurate diagnosis and the development of new treatments. The frequent mutations suggest a potential therapeutic target for recurrent or metastatic MLA.