From the Research
Mesonephric duct rests are remnants of the mesonephric (Wolffian) ducts that persist in the female reproductive tract after normal development, typically found in the lateral walls of the vagina, cervix, and broad ligament of the uterus. These remnants originate from the mesonephric ducts, which usually regress in female embryos but sometimes leave behind small clusters of tissue 1. Mesonephric duct rests appear microscopically as small tubular structures lined with cuboidal or columnar epithelium. While usually asymptomatic and discovered incidentally during pathological examination, they occasionally develop into mesonephric hyperplasia or, rarely, mesonephric adenocarcinoma. The persistence of these structures is due to incomplete regression of the Wolffian system during embryonic development when the female reproductive tract is forming from the Müllerian ducts. Some key points to consider about mesonephric duct rests include:
- They are remnants of embryonic structures that persist in the female reproductive tract
- They originate from the mesonephric (Wolffian) ducts
- They are most commonly found in the lateral walls of the vagina, cervix, and broad ligament of the uterus
- They can develop into mesonephric hyperplasia or, rarely, mesonephric adenocarcinoma
- Clinicians should be aware of these normal variants to avoid misdiagnosis as pathological lesions, particularly when evaluating tissue samples from gynecological procedures 1. It is essential to distinguish mesonephric duct rests from other lesions, such as minimal deviation adenocarcinoma, to ensure accurate diagnosis and appropriate management 2. The expression of PAX2, a transcription factor necessary in the development of the Wolffian duct system, can be useful in distinguishing mesonephric hyperplasia from minimal deviation adenocarcinoma 2. However, the most recent and highest quality study on this topic is from 2018, which provides a comprehensive review of mesonephric proliferations of the female genital tract 1.