# Mesonephric Hyperplasia and Adenocarcinoma of the Cervix: A Rare Evolution, Case Report, and Review of the Literature

## TL;DR

A rare case of cervical cancer evolving from mesonephric hyperplasia is reported, emphasizing the need for early detection and accurate diagnosis.

## Contribution

This case report adds to the limited literature on mesonephric adenocarcinoma of the cervix and its progression from mesonephric hyperplasia.

## Key findings

- Mesonephric hyperplasia can progress to mesonephric adenocarcinoma of the cervix.
- Early detection and radical surgery improve outcomes in this rare cancer.

## Abstract

Background and Clinical Significance: Mesonephric adenocarcinoma (MA) of the uterine cervix is an exceptionally uncommon and aggressive cancer that arises from remnants of the mesonephric duct. It was first classified by the World Health Organization (WHO) in the 2020 WHO Classification of Female Genital Tumors as a type of cervical adenocarcinoma, also referred to as Gartner’s duct carcinoma. Due to its rarity, both detection and treatment pose significant challenges, and there is little information on its clinical manifestations and prognosis. Mesonephric hyperplasia (MH) in the uterine cervix is an uncommon condition that is often misdiagnosed as adenocarcinoma. Case Presentation: We present the case of a 49-year-old, asymptomatic, perimenopausal woman diagnosed with cervical mesonephric adenocarcinoma following a routine Pap smear, performed by Papanicolaou test, with a III A-B result; however, a cone biopsy revealed stage IB1 mesonephric adenocarcinoma. The patient underwent a radical hysterectomy type C (Querleu–Morrow 2017 classification). The final pathology confirmed stage IB2 of the cancer (2018 classification) according to The International Federation of Gynecology and Obstetrics (FIGO), with previous evidence of mesonephric hyperplasia from a trial abrasion performed three years earlier. Conclusions: This case highlights the challenges in recognizing and managing mesonephric hyperplasia and adenocarcinoma of the cervix. Given the uncommon nature of this cancer, clinicians should consider it when treating patients with ambiguous cervical pathology and mesonephric hyperplasia. Optimizing patient outcomes relies on early detection, accurate staging, and radical surgical treatment.