Concurrent primaries of vaginal clear cell adenocarcinoma and endometrial adenocarcinoma in a 39-year old woman with in utero diethylstilbestrol exposure

Abstract

Diethylstilbestrol (DES) was used widely in the late 1940s in an attempt to prevent adverse pregnancy outcomes. In 1971 the US Food and Drug Administration proscribed its use for pregnancy support secondary to its association with clear cell adenocarcinoma of the vagina. Several studies in animal models demonstrated an association with endometrial cancer among offspring following in utero DES exposure. To date, there is only one case report of endometrial cancer in women exposed to DES in utero. We present the first case, to our knowledge, of a woman exposed to DES in utero who presented with double primaries of clear cell cancer of the vagina concomitant with endometrial cancer.

Fertility sparing treatment of vaginal clear cell adenocarcinoma in a DES-Naïve young woman

“…DES is a synthetic estrogen that was prescribed to pregnant women between 1940 and 1971 and was thought to prevent miscarriage and preterm birth. Although there is reportedly a strong association between DES and development of vaginal adenocarcinoma of the fetus ( Monaghan and Sirisena, 1978 , Keller et al, 2001 ), there have been few cases of vaginal adenocarcinoma in the absence of DES exposure ( Uehara et al, 2010 , Ikeda et al, 2014 , Alipour et al, 2008 , Zeeshan-ud-din, 2009 ) including the case presented here.…”

Neonatal estrogenic exposure suppresses PTEN-related endometrial carcinogenesis in recombinant mice

“…61,62 Although 705 cases of clear-cell adenocarcinomas of the vagina and cervix have been reported, there were only two pathologically confirmed case reports of endometrial carcinomas. 63,64 In a recent cohort study, the incidence of endometrial carcinomas in DESexposed persons was lower than that of unexposed persons. 65 These findings in human might be consistent with this study using the mice model.…”