| Title: |
Highlighting the molecular refinement of NSMP endometrial cancer in a case of mesonephric-like adenocarcinoma |
| Authors: |
Katharina Steger; Simon Schnaiter; Sigurd Lax; Dave Bandke; Daniel Reimer; Christian Marth; Alain G. Zeimet |
| Source: |
Gynecologic Oncology Reports, Vol 64, Iss , Pp 102052- (2026) |
| Publisher Information: |
Elsevier |
| Publication Year: |
2026 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Endometrial cancer; NSMP; Mesonephric-like adenocarcinoma; L1CAM; Prognostic markers; Gynecology and obstetrics; RG1-991; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282 |
| Description: |
Background: The 2025 ESGO/ESTRO/ESP guideline for endometrial carcinoma (EC) integrates molecular classification into clinical decision-making and, for the first time, recommends the subdivision of carcinomas with no specific molecular profile (NSMP) according to estrogen receptor (ER) status and histological grading. However, NSMP carcinomas remain a highly heterogeneous subgroup, posing challenges in terms of diagnosis and therapy. Case presentation: We report the case of a 71-year-old female patient with low-grade NSMP EC. Due to ER-negativity and strong L1 cell adhesion molecule (L1CAM) expression, the German/Austrian/Swiss S3 guideline at that time required comprehensive histopathological reassessment, which reclassified the tumor as mesonephric-like adenocarcinoma. Extended molecular profiling further identified a KRAS mutation and the absence of common alterations in PTEN, PIK3CA, and PIK3R1. These features correspond to the aggressive “Cluster 3” subgroup of NSMP tumors, characterized by ER-negativity, L1CAM positivity, KRAS mutations, and frequent chromosome 1q gain. The patient therefore underwent adjuvant carboplatin/paclitaxel chemotherapy followed by vaginal brachytherapy and has remained recurrence-free for five years. Conclusion: This case demonstrates molecular classification of an unusual histological type of EC exhibiting an extremely short-term risk of early distant metastasis and its implication on aggressive adjuvant therapeutical approach. It, furthermore, exemplifies the pronounced heterogeneity of the NSMP subgroup. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2352578926000329; https://doaj.org/toc/2352-5789; https://doaj.org/article/19e274d3d558420bb498dd6e92441025 |
| DOI: |
10.1016/j.gore.2026.102052 |
| Availability: |
https://doi.org/10.1016/j.gore.2026.102052; https://doaj.org/article/19e274d3d558420bb498dd6e92441025 |
| Accession Number: |
edsbas.57ECA5F8 |
| Database: |
BASE |