A mRNA sequencing sample of Sex Cord-Like Ovarian Endometrioid Carcinoma

The purpose and necessity of mRNA sequencing in this case of Ovarian Endometrioid Carcinoma with Sex Cord Like Structureslie in its critical role in unraveling the molecular mechanisms underlying the tumor's unique morphological remodeling; by performing transcriptome profiling, we aimed to clarify why an epithelial carcinoma mimics the histological architecture of sex cord-stromal tumors, identify the core driver alterations such as the specific CTNNB1 mutation and its downstream beta-catenin signaling activation, and delineate the tumor immune microenvironment. This approach was essential to resolve diagnostic ambiguity, as the histopathological features closely resembled granulosa cell tumors, and conventional immunohistochemistry alone could not definitively differentiate them; moreover, the sequencing results revealed significant downregulation of the Rap1 signaling axis, providing a molecular explanation for disrupted cell adhesion and loss of polarity leading to structural transformation, while also showing negative enrichment of immune-related pathways, indicating an immune-cold tumor phenotype with potential resistance to immune checkpoint inhibitors, thereby guiding appropriate therapeutic strategies and avoiding ineffective treatments.