Abstract:

Mesonephric-like adenocarcinoma of the endometrium is a rare gynecological malignancy. Due to the low incidence, strong invasiveness, easy recurrence and metastasis, patients with this kind of disease are usually seen at an advanced stage. There is no clear treatment plan at present, and the prognosis is poor. We report the diagnosis and treatment process of a patient with mesonephric-like adenocarcinoma of the endometrium involving cervical interstitium. The patient was treated for two times of postmenopausal vaginal fluid and irregular vaginal bleeding for more than 20 days. Hysteroscopy (primary surgery) was performed on November 18, 2022, and the postoperative pathological examination results showed endometrioid adenocarcinoma. Therefore, transabdominal extrascial hysterectomy, bilateral ovarian arteriovenous high ligation, bilateral salpingo-oophorectomy, abdominal para-aortic lymphadenectomy and pelvic lymph node dissection (secondary surgery) was performed on December 1, 2022. Combined with the results of pathological examination of the two surgeries, stage Ⅱ of mesonephric-like adenocarcinoma of the endometrium was diagnosed. After surgery, the patient was given five cycles of paclitaxel combined with carboplatin chemotherapy, one course of pelvic external beam radiotherapy and one vaginal brachytherapy. No disease recurrence or metastasis was observed during follow-up until April 10, 2024.

Key words: Endometrium, Adenocarcinoma, Endometrial neoplasms, Diagnosis, Therapy