Mesonephric-like Carcinosarcoma of the Uterine Corpus: Clinicopathological, Molecular and Prognostic Characteristics in Comparison With Uterine Mesonephric-like Adenocarcinoma and Conventional Endometrial Carcinosarcoma

Abstract

Background/Aim: This study aimed to investigate the clinicopathological, prognostic and molecular characteristics of uterine mesonephric-like carcinosarcoma (MLCS). Patients and Methods: We collected clinical,

Mesonephric-like adenocarcinoma of the female genital tract: possible role of KRAS-targeted treatment—detailed molecular analysis of a case series and review of the literature for targetable somatic KRAS-mutations

“…Some studies did not examine the KRAS -mutational status of their reported cases and focused on morphologic findings and/ or clinical features (Pors et al 2021 ). Other studies performed molecular analyses but did not report the results in detail (Park et al 2022 ).…”

“…On immunohistochemistry, MLA show negativity or limited positivity for estrogen receptor staining and positive staining for TTF-1, CD 10 (Fig. 1 e–g) and GATA-3 in most cases as well as for calretinin in some cases (Mirkovic et al 2018 ; Euscher et al 2020 ; Park et al 2022 ; McCluggage 2022 ).…”

“…Compared to endometrioid and serous endometrial carcinomas, MLA showed the lowest median progression-free survival [183 versus 67.1 versus 18.2 months; p < 0.0001 (Euscher et al 2020 )]. Pulmonary involvement, detected in up to 60% of endometrial MLA, is the most common site of distant spread (Kim et al 2021 ; Park et al 2022 ; da Silva et al 2021 ; Euscher et al 2020 ). Hepatic metastatic spread is ten times higher in patients with endometrial MLA compared to endometrioid endometrial carcinomas and five times more frequent when compared to those with serous tumors (Pors et al 2021 ; Euscher et al 2020 ; Mao et al 2020 ).…”

“…Other uncommon metastatic sites are the brain, spleen, and vertebrae (Pors et al 2021 ; Deolet et al 2021 ). Although many cases of endometrial MLA may be associated with adverse prognostic factors, such as large tumor size, deep myometrial involvement, cervical stromal invasion, involvement of lymphatic and/or blood vessels, and retroperitoneal lymphatic spread (Na and Kim 2019 ; Park et al 2022 ; Kim et al 2022 ; Euscher et al 2020 ), there is an increasing evidence that the presence of a mesonephric-like histology itself may represent an independent poor prognostic feature (Euscher et al 2020 ; Pors et al 2021 ; Al Nabhani et al 2022 ).…”

“…Previously published cases of uterine and ovarian MLA were re-evaluated for molecular results focusing on KRAS -mutations (Mirkovic et al 2018 ; Chapel et al 2018 ; Patel et al 2018 ; Na and Kim 2019 ; Yano et al 2019 ; Kolin et al 2019 ; McCluggage et al 2020 ; Dundr et al 2020 ; Horn et al 2020 ; Euscher et al 2020 ; Seay et al 2020 ; da Silva et al 2021 ; Deolet et al 2021 ; Ma et al 2022 ; Kim et al 2021 , 2022 ; Mills et al 2022 ; Park et al 2022 ; Al Nabhani et al 2022 ; Deolet et al 2022 ; Koh et al 2022 ). Those cases were analyzed for the frequency of KRAS -mutation (wild type versus mutated).…”