Vaginal Clear Cell Adenocarcinoma With Early Pulmonary Metastasis in a Child

Abstract

Although a few cases of vaginal clear cell adenocarcinoma (CCAC) have been reported in the ages under 14, they have presented in a much more aggressive form than the CCAC cases in higher ages and parenchymal pulmonary metastasis are known to occur following the primary tumor. This is a case report of a primary vaginal CCAC in an 8.6-year-old girl with no history of DES exposure who presented with vaginal bleeding and abdominal pain and the imaging signs of pulmonary metastasis at the presentation. Diagnostic imaging modalities should be considered for any child complaining of vaginal bleeding, due to limitation of vaginal examination. Chest X-ray is recommended at the time of diagnosis of CCAC and at follow-up sessions for early diagnosis of pulmonary metastasis.

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.…”

Successful Treatment of an Adolescent With Locally Advanced Cervicovaginal Clear Cell Adenocarcinoma Using Definitive Chemotherapy and Radiotherapy

“…[1][2][3][4][5][6][7][8][9] CCA may involve any portion of the vagina, uterine cervix, or both, with the majority of tumors confined to the anterior wall of the upper third of the vagina. In comparison to squamous cell carcinoma, CCA tends to be slower growing with a greater propensity for distant metastasis and late recurrence.…”