Obstet Gynecol Sci.  2016 Jul;59(4):328-332. 10.5468/ogs.2016.59.4.328.

A female adnexal tumor of probable Wolffian origin showing positive O-6-methylguanine-DNA methyltransferase methylation

• Kwon MJ
• Yun MJ
• Kim MK

• KMID: 2329057
• DOI: http://doi.org/10.5468/ogs.2016.59.4.328

Abstract

Female adnexal tumor of probable Wolffian origin (FATWO) is a rare disease entity that arises from the mesonephric duct system. FATWO is different than other gynecological cancers in terms of embryology. Here, we describe the case of a 52-year-old woman with malignant FATWO. The patient underwent explorative laparotomy and surgical staging after a frozen section revealed malignancy. Detailed examination of the pathologic findings were consistent with FATWO. Counseling and further testing were provided to the patient to assess the risk of germline mutation and epigenetic change. An O-6-methylguanine-DNA methyltransferase gene methylation test was positive, and all other tests were normal. This is the first study to report a case of O-6-methylguanine-DNA methyltransferase methylation with FATWO in Korea.

Keyword

Epigenesis, Genetic; O(6)-methylguanine-DNA methyltransferase methylation; Wolffian tumor

MeSH Terms

Counseling
Embryology
Epigenesis, Genetic
Epigenomics
Female*
Frozen Sections
Germ-Line Mutation
Humans
Korea
Laparotomy
Methylation*
Middle Aged
Rare Diseases
Wolffian Ducts

Figure

• 

  Fig. 1 Computed tomography scan (A), gross findings (B), and microscopic findings (×100). (C) Frequent mitosis is present (×400). (D) show cystic and adenomatoid patterns with colloid like material. The nuclei has a vesicular appearance with conspicuous nucleoli and an irregular nuclear membrane.

• 

  Fig. 2 O-6-methylguanine-DNA methyltransferase methylation analysis. DW, distilled water; M, methylation polymerase chain reaction (PCR) product (81 bp); U, unmethylation polymerase chain reaction product (93 bp).

Reference

1. Kariminejad MH, Scully RE. Female adnexal tumor of probable Wolffian origin: a distinctive pathologic entity. Cancer. 1973; 31:671–677.

2. Tamiolakis D, Anastasiadis P. Metastatic female adnexal tumour of probable Wolffian origin: a histocytopathological correlation. Cytopathology. 2007; 18:264–266.

3. Heatley MK. Is female adnexal tumour of probable wolffian origin a benign lesion? A systematic review of the English literature. Pathology. 2009; 41:645–648.

4. Marquette A, Moerman P, Vergote I, Amant F. Second case of uterine mesonephric adenocarcinoma. Int J Gynecol Cancer. 2006; 16:1450–1454.

5. Wolffe AP, Matzke MA. Epigenetics: regulation through repression. Science. 1999; 286:481–486.

6. Deshimaru R, Fukunaga T, Sato T, Morinaga S, Takahashi M. A case of metastatic female adnexal tumor of probable Wolffian origin. Gynecol Oncol Rep. 2014; 10:22–24.

7. Kurita T. Normal and abnormal epithelial differentiation in the female reproductive tract. Differentiation. 2011; 82:117–126.

8. Harada O, Ota H, Takagi K, Matsuura H, Hidaka E, Nakayama J. Female adnexal tumor of probable wolffian origin: morphological, immunohistochemical, and ultrastructural study with c-kit gene analysis. Pathol Int. 2006; 56:95–100.

9. Tiltman AJ, Allard U. Female adnexal tumours of probable Wolffian origin: an immunohistochemical study comparing tumours, mesonephric remnants and paramesonephric derivatives. Histopathology. 2001; 38:237–242.

10. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011; 144:646–674.

11. Gerhauser C. Epigenetic impact of dietary isothiocyanates in cancer chemoprevention. Curr Opin Clin Nutr Metab Care. 2013; 16:405–410.

12. Liu L, Gerson SL. Targeted modulation of MGMT: clinical implications. Clin Cancer Res. 2006; 12:328–331.

13. Watts GS, Pieper RO, Costello JF, Peng YM, Dalton WS, Futscher BW. Methylation of discrete regions of the O6-methylguanine DNA methyltransferase (MGMT) CpG island is associated with heterochromatinization of the MGMT transcription start site and silencing of the gene. Mol Cell Biol. 1997; 17:5612–5619.

14. Yang HJ, Liu VW, Wang Y, Tsang PC, Ngan HY. Differential DNA methylation profiles in gynecological cancers and correlation with clinico-pathological data. BMC Cancer. 2006; 6:212.