To the Editor: Primary vaginal carcinoma is a rare malignant disease, which represents only approximately 1% to 2% of female genital malignancies. Vaginal adenosis is defined by the presence of metaplastic cervical or endometrial epithelium within the vaginal wall, and is associated with a high risk of vaginal carcinoma. In women prenatally exposed to diethylstilboestrol (DES), vaginal adenosis may arise in up to 90%, and these are often associated with vaginal clear cell adenocarcinoma. [1] DES is an orally active non-steroidal estrogen. The Food and Drug Administration began a clinical trial in 1943, and concluded that DES administration is beneficial for preventing premature deliveries and miscarriages. [2] In addition to primary vaginal clear cell carcinoma (PVCCC), in-uterus exposure to DES can also lead to T-shaped uterus anomaly. [3] In the Chinese population, PVCCC is an uncommon malignancy, and there are no reports on the relationship between PVCCC and DES exposure. [4] Given the rarity of PVCCC, it is significant to analyze relevant cases, and provide some valuable information for future clinical and basic studies. Therefore, the present study described ten cases of PVCCC, and summarized the characteristics of the diagnosis, management, and prognosis of these patients.A total of 228 patients were diagnosed with vaginal malignancy. Furthermore, 11 patients were diagnosed Sikai Chen and Zhiyue Gu contributed equally to this work.

Purpose To classify abdominal wall endometriosis (AWE) according to the invasive levels of tissue mass, and to compare the differences in clinical characteristics between different types of AWE. Methods In this study, we retrospectively analyzed the clinical data of 367 patients who had undergone resection of abdominal-wall endometriotic lesions at the Peking Union Medical College Hospital from January 2008 to December 2018, and we divided the patients into three types according to their deepest level of lesion invasion. Type I designated invasion of skin and subcutaneous tissue; type II, of fascia and rectus abdominis; and type III, of peritoneum. We classified, compared, and analyzed the general conditions, clinical manifestations, auxiliary examinations, surgical conditions, postoperative conditions, and recurrence status of patients. Result s Of the 367 patients, type I patients accounted for 13.62%, type II patients for 56.68%, and type III for 29.7%. With respect to group comparisons, we observed that as the location of the mass deepened, the rate of concurrent pelvic endometriosis increased (P = 0.007), recurrent AWE was augmented (P = 0.02), the size of the mass increased (P < 0.001), the rate of multiple lesions became elevated (P < 0.001), the rate of mesh implantation increased (P < 0.001), the length of postoperative hospital stay (P < 0.001) was lengthened, the number of postoperative fever cases (P = 0.006) increased, and the risk of drainage placement (P < 0.001) was enhanced. The 5-year cumulative recurrence rate was 3.3%, and there was no significant difference in the recurrence rate among various types of AWE. Conclusion Various types of AWE manifest different clinical characteristics, surgical options, associations with pelvic endometriosis, and postoperative conditions.