We report a case of primary clear cell adenocarcinoma of the vagina in a 72-year-old woman. The tumor arised in the anterior to left vaginal wall at the introitus and showed signs of ulceration. A PAP smear revealed atypical round cells containing clear and abundant cytoplasm and round nuclei, with one to several prominent nucleoli in sheet-like clusters. Some nuclei with almost no cytoplasm and were scattered around the clusters.
Histologically, the tumor consisted of two portions: a clear cell adenocarcinoma and a less-differentiated adenocarcinoma.