Mesonephroma ovarii (hypernephroid carcinoma). Light microscopic and ultrastructural study of a case.
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A case of mesonephric adenocarcinoma of the uterine cervix arising in florid mesonephric hyperplasia is reported. The reviewed literature contained many cases of cervical "mesonephroma" but only a few of these were considered to be demonstrably of mesonephric origin. These tumors were usually associated with proliferating mesonephric remnants in the cervix. Similar tubuloglandular mesonephric proliferations without formation of a frankly malignant tumor have also been described in the cervix, most recently as florid mesonephric hyperplasia. This latter entity appears to be benign. Carcinoembryonic antigen (CEA) was focally positive in this cervical adenocarcinoma, suggesting that CEA may not be useful in distinguishing this variant from the more common mullerian adenocarcinoma of the cervix.
Three cases of Endodermal Sinus Tumor are presented and its difference from tumors of the mesonephroma type and associations with the embryoma are pointed out. The three cases were "pure" types and the patients died within 5 months in spite of surgical treatment and chemotherapy. Autopsy showed extensive involvement of peritoneum, diaphragm and pleura.
The fine structure of an ovarian clear cell carcinoma in a 65 year old woman was analysed. The tumor cells were of both clear and "hobnail" types. Both were characterized by the presence of short microvilli, abundant glycogen granules, a well-developed granular endoplasmic reticulum and Golgi apparatus, scanty lysosomes and very few lipid bodies. The tubules and gland-like spaces were always separated from the stroma by a basement membrane. At ultrastructural level the tumor cells do not resemble at all those of cleaar cell renal carcinomas. On the other hand, their submicroscopic features are strongly similar to those of the clear cell tumors found elsewhere in the female genital tract, emphasizing therewith their very probable müllerian origin. It is recommended to eliminate the term "mesonephroma ovarii" to designate the clear cell carcinomas of the ovary.
A 49-year-old black woman developed a urethral glycogen-rich clear cell carcinoma. She was treated with anterior pelvic exenteration. The resected lymph nodes, vagina, uterine cervix, endometrium, ovaries, and urinary bladder were free of neoplasm. Histologically the neoplasm consisted of clear cells growing in sheets and occasional papillary structures. In some areas, hobnail cells were present. Ultrastructurally, the cells had apical caps, short microvilli, and complex cell bases, and contained abundant glycogen. These features were identified in one, but not the other of two previously reported cases. Because glycogen-rich clear cell carcinomas of the lower urinary tract do not resemble ultrastructurally mesonephric remnants or carcinomas known to arise from them, these glycogen-rich clear cell carcinomas should not be called "mesonephromas" as has been the practice.