Adenocarcinoma of the Vagina

TLDR

Adenocarcinoma of the vagina is a rare malignancy in young women, with only a handful of cases reported before the 1966‑69 series at Vincent Memorial Hospital. The study aimed to identify factors associated with this uncommon tumor by retrospectively examining eight New England patients born between 1946 and 1951. Researchers matched each patient with four controls and collected data through personal interviews. Maternal bleeding and pregnancy loss were more frequent in the study group, and seven of eight mothers had received diethylstilbestrol during the first trimester—an exposure absent in controls—suggesting that early‑pregnancy stilbestrol ingestion markedly elevates the risk of vaginal adenocarcinoma in offspring.

Abstract

Adenocarcinoma of the vagina in young women had been recorded rarely before the report of several cases treated at the Vincent Memorial Hospital between 1966 and 1969. The unusual occurrence of this tumor in eight patients born in New England hospitals between 1946 and 1951 led us to conduct a retrospective investigation in search of factors that might be associated with tumor appearance. Four matched controls were established for each patient; data were obtained by personal interview. Results show maternal bleeding during the current pregnancy and previous pregnancy loss were more common in the study group. Most significantly, seven of the eight mothers of patients with carcinoma had been treated with diethylstilbestrol started during the first trimester. None in the control group were so treated (p less than 0.00001). Maternal ingestion of stilbestrol during early pregnancy appears to have enhanced the risk of vaginal adenocarcinoma developing years later in the offspring exposed.