Here, we report a case of mucin-depleted usual-type ECA resembling endometrioid adenocarcinoma (EEC) in morphology and immunohistochemistry (IHC) and confirm the final diagnosis with the aid of high-risk HPV RNAscope detection to assure high-risk HPV infection in situ. Here, MUC5AC is linked to exstrophy-epispadias complex.