Clear cell carcinoma of the cervix and vagina in young women. A report of six cases with association of maternal stilbestrol therapy and adenosis of the vagina.

Abstract

Abstract Six young women, between the ages of 16 and 20 years, with clear cell carcinoma (4 of the vagina and 2 of the cervix) were treated at the University of California, San Francisco, Medical Center from 1968 through 1971. Irregular vaginal bleeding was the primary symptom. The lesions were described as papillary, fungating, nodular, or granular and showed no predilection for a specific level in the lower reproductive tract. A high degree of associated adenosis of the vagina was noted. Pelvic lymph node metastases were found in 3 patients. Radical pelvic operation has been effective in the management. Two patients have developed isolated distant metastases, but all 6 are living and well one to 4 years following the initiation of treatment. In 5 cases there was a reliable history of maternal hormone administration during pregnancy. There is good evidence that these tumors are of the paramesonephric (Mullerian) duct rather than the mesonephric (Wolffian) duct in origin.