Introduction/Background Mesonephric adenocarcinomas (MA) of the female genital tract are rare tumors originating from mesonephric duct remnants, which mainly occur in cervix followed by ovarian hilum and broad ligament, and rarely in uterine corpus and lateral wall of vagina. The diagnosis of MA is challenging as it exhibits mixture of histomorphological pattern that can be confused with endometrioid, serous, clear cell carcinomas and sex cord stromal tumors of female genital tract. Similar tumors cervix or paravaginal area are labeled as mesonephric like adenocarcinoma (MLA). KRAS is the most common molecular alteration seen in MA and MLA.

Methodology We present three such rare cases of MA and MLA with challenging diagnostic features.

Results All our 3 cases were post-menopausal females. One of the cases was diagnosed as MA of the cervix, and 2 cases as MLA from ovary. All the cases were positive for PAX-8, GATA-3, TTF-1.All 3 cases exhibited KRAS mutation in exon 2, using real-time polymerase chain reaction (RT-PCR).

Conclusion The application of a panel of immunohistochemical markers can help in correct diagnosis while ruling out the mimickers. Treatment of these tumors is based on the stage, and they usually show aggressive biological behavior with increased risk of recurrence.

Disclosures

• Financial Disclosure: Authors have no financial implications to disclose

• Conflict of interest: Authors declare no conflict of interest