Mesonephric-like adenocarcinoma as an unexpected histological result after fertility saving procedure for presumed adenomyosis: a case report
By
Vojtěch Lukavec
Filip Frühauf
Zdenka Lisa
Jan Galko
Pavel Dundr
Michal Mara
June 5, 2026
Clinical Scorecard: Unexpected Diagnosis of Mesonephric-like Adenocarcinoma Following Fertility Preservation for Suspected Adenomyosis: A Case Study
At a Glance
Category Detail
Condition Mesonephric-like adenocarcinoma Key Mechanisms Malignant transformation of adenomyotic lesions, characterized by atypical myometrial lesions mimicking adenomyosis. Target Population Women with primary infertility and suspected adenomyosis, particularly those aged 36-76. Care Setting Tertiary minimally invasive gynecological center.
Key Highlights
Unexpected diagnosis of mesonephric-like adenocarcinoma during treatment for suspected adenomyosis. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy after initial misdiagnosis. Malignant transformation of adenomyosis is rare but can occur, necessitating thorough evaluation. Guideline-Based Recommendations
Diagnosis
Utilize the revised MUSA criteria for evaluating myometrial lesions. Consider histopathological evaluation for atypical myometrial lesions. Management
Cytoreductive surgery may be considered for symptomatic patients resistant to other treatments. Monitoring & Follow-up
Monitor for recurrence and metastasis, especially in cases of mesonephric-like adenocarcinoma. Risks
High risk of complications associated with debulking surgery, including uterine rupture in future pregnancies. Patient & Prescribing Data
41-year-old female with primary infertility and heavy menstrual bleeding.
Patient received six cycles of paclitaxel and carboplatin plus pembrolizumab-based immunotherapy post-surgery.
Clinical Best Practices
Conduct thorough evaluations of all atypical myometrial lesions. Consider pre-conception surgical excision and histopathological evaluation. Related Resources & Content
