A case with no history of exposure to diethylstilbestrol with vaginal clear cell adenocarcinoma

Abstract

Background : Primary vaginal clear cell adenocarcinoma (PVCCA) is extremely uncommon with squamous cell carcinoma, the most common type of vaginal cancer. PVCCA of the vagina developing in patients without a history of exposure to diethylstilbestrol (DES) and without urogenital anomalies or adenosis is very rare. We present a case of PVCCA in a patient with no congenital urogenital anomalies or history of exposure of DES.

Case : The patient was a 50-year-old postmenopausal woman, gravida 1, who presented with abnormal genital bleeding. MRI showed an enhancing tumor in the mid-to lower section of the vagina. The pathological diagnosis was clear cell adenocarcinoma. The patient was treated by local resection and adjuvant chemotherapy in deference to her wish based on her religious beliefs. The final diagnosis was PVCCA, FIGO stage Ⅰ (pT1NXM0). She remains recurrence-free to date.

Conclusion : This rare PVCCA may be associated with a poor prognosis. It is important to detect this malignancy its complications in the early stage by cytology.