Post-stilbestrol secondary syndrome.

Abstract

15 adolescent and postadolescent females who had been exposed to stilbestrol prenatally were thoroughly examined and biopsied. Their ages ranged from 15-23 years. At least 4 nonmalignant lesions not previously noted in such patients occurred with high frequency and were thought to be related to the use of stilbestrol. The lesions were an upper vaginal hood a strawberry cervix and cervical portio cocks comb and an endocervical tumor formation. These lesions can be palpated with 1-finger examination. No relaionship of these lesions to adenocarcinoma was demonstrated but there is a definite need for further followup of these patients and others similarly exposed. Adenocarcinoma was seen in 1 patient. This patient underwent a radical hysterectomy and total vaginectomy pelvic node dissection and graft replacement of the vagina. All of the nodes were free of tumor. The patient did well except for persistent urinary retention and urinary tract infection which eventually resolved with treatment. The patient remains well after 1-1/2 years. Granular appearing posterior fornix was seen only once and biopsy demonstrated acute and chronic vaginitis. No instance of vaginal adnosis was seen except in the patient with adenocarcinoma.