Clear cell adenocarcinoma of the vagina

Clear cell adenocarcinoma of the vagina
Classification and external resources

Clear cell adenocarcinoma of the vagina is a rare type of vaginal cancer that is characterized by the presence of clear cells in the tumor. This type of cancer is most commonly associated with prenatal exposure to the synthetic estrogen diethylstilbestrol (DES), which was prescribed to pregnant women between the 1940s and 1970s to prevent miscarriages and other pregnancy complications.

Epidemiology

Clear cell adenocarcinoma of the vagina is a rare malignancy, accounting for a small percentage of all vaginal cancers. It is most frequently diagnosed in young women, particularly those in their late teens and early twenties, who were exposed to DES in utero.

Pathophysiology

The pathogenesis of clear cell adenocarcinoma is linked to the disruption of normal cellular differentiation in the developing fetal reproductive tract due to DES exposure. The clear cells in the tumor are so named because of their appearance under the microscope, which is due to the presence of glycogen within the cells.

Clinical Presentation

Patients with clear cell adenocarcinoma of the vagina may present with symptoms such as abnormal vaginal bleeding, pelvic pain, or a palpable mass. In some cases, the cancer may be asymptomatic and discovered incidentally during a routine gynecological examination.

Diagnosis

Diagnosis of clear cell adenocarcinoma typically involves a combination of pelvic examination, imaging studies such as MRI or CT scan, and a biopsy of the lesion. Histopathological examination of the biopsy sample is crucial for confirming the diagnosis.

Treatment

The treatment of clear cell adenocarcinoma of the vagina depends on the stage of the disease at diagnosis. Options may include:

• Surgical resection of the tumor
• Radiation therapy
• Chemotherapy

The choice of treatment is influenced by factors such as the size and location of the tumor, the patient's age, and overall health.

Prognosis

The prognosis for patients with clear cell adenocarcinoma of the vagina varies. Early-stage disease has a better prognosis, while advanced disease with metastasis may have a poorer outcome. Long-term follow-up is essential for monitoring recurrence.

Prevention

Since DES is no longer used, the incidence of clear cell adenocarcinoma related to DES exposure is expected to decline. However, awareness and monitoring of individuals exposed to DES remain important.

Also see

• Vaginal cancer
• Diethylstilbestrol
• Adenocarcinoma
• Gynecologic oncology