Clear cell adenocarcinoma of the cervix in second generation young women who are without maternal exposure to diethylstilbestrol: A case report

Abstract

Clear cell adenocarcinoma of the cervix (CCAC) is a rare type of gynecological cancer. The risk factors and pathogenesis have yet to be clearly determined. This is a case report of a 19-year-old woman, who was never exposed to DES from her mother, who had gone for an examination for vaginal bleeding. A polypoid mass measured at 3 cm presenting in her cervix was discovered. Histological diagnosis following cervical biopsy proved the tumor to be a clear cell carcinoma. The patient was then referred to our hospital. A loop electrosurgical excision procedure (LEEP) was done and the pathological diagnosis was confirmed for clear cell carcinoma with a positive endocervical margin. Radical hysterectomy, pelvic lymphadenectomy and incidental appendectomy were achieved without any complications. The microscopic findings had revealed no residual tumor. The patient did not require adjuvant treatment. No sign of recurrence has been detected throughout 6 months of follow-up. We have performed the literature review on the clinical presentation, pathogenesis, pathology, diagnosis, treatment, and prognosis of this unusual tumor.

Keywords: Cervical cancer; Clear cell adenocarcinoma; Diethylstilbestrol; Young woman.

Fig. 1

Tumor cells are composed of a tubulocystic pattern of cells with abundant clear cytoplasm and large irregular nuclei. (Hematoxyline and eosin staining, original magnification 40 ×.)

Fig. 2

Microscopically, the tumor cells invade endocervical tissue without definite lymphatic invasion. (Hematoxyline and eosin staining, original magnification 10 ×.)