A Rare Case of Clear Cell Adenocarcinoma of the Cervix in a Neurologically Disabled Patient

Abstract

A 15-year-old neurologically disabled patient was referred to our hospital because of continuous vaginal bleeding lasting more than 1 year. Magnetic resonance imaging revealed a 49 mm intrapelvic solitary mass that was suspected to be rhabdomyosarcoma. Urinary bladder invasion was suspected on the basis of computed tomography findings. She underwent open surgical biopsy because an adequate amount of tissue could not be obtained by a vaginoscope-guided biopsy, and she was histopathologically diagnosed as having clear cell adenocarcinoma of the cervix (CCAC). She underwent total abdominal hysterectomy and bilateral oophorectomy to control the bleeding 15 days after the open surgical biopsy. Urinary bladder invasion was confirmed by intraoperative findings, so she was diagnosed as having CCAC, stage IVA, in accordance with the FIGO classification. The vaginal bleeding stopped after hysterectomy, and she was transferred to a recuperation hospital. Five months after the hysterectomy, her quality of life was maintained, although intermittent vaginal bleeding and local recurrence were confirmed by computed tomography. When examining children with vaginal bleeding or intrapelvic masses, it is important to consider CCAC. It is also important to decide on treatment strategies with due consideration of the curability and quality of life.