Clear-cell adenocarcinoma of the vagina (and/or cervix) is a rare adenocarcinoma often linked to prenatal exposure to diethylstilbestrol (DES), a drug which was prescribed in high-risk pregnancy.
Clear-cell adenocarcinoma of the vagina (and/or cervix)
After age 30 it was thought that women exposed prenatally, "DES daughters", were no longer at risk for the disease, but as they age into their 40s and 50, cases continue to be reported.[1]
Clear-cell adenocarcinoma of the vagina is a rare cancer, occurring in up to 10% of primary vaginal malignancies. It is all but confirmed if maternal use of DES is established. Even though it was once thought to no longer occur past the age of 30, it is still seen in the 40s and 50s. Some of the main signs and symptoms for clear-cell adenocarcinoma of the vagina are spotting between menstrual cycles, bleeding post-menopause, abnormal bleeding, and malignant pericardial effusion or cardiac tamponade.[4]
Treatmentedit
Low grade cancer is treated by surgical resection. High grade will require neoadjuvant chemotherapy and resection. Long-term surveillance will be required.[4]
Historyedit
The synthetic estrogen DES was given to millions of pregnant women in the United States and other countries. Use in the US was primarily from 1938 to 1971 but not limited to those years. Internationally, DES use continued until the early 1980s. DES was given if a woman had a previous miscarriage, diabetes, or a pregnancy with bleeding, threatened miscarriage or premature labor.
Up until the mid to late 1950s some women were given DES shots. After that, DES was primarily prescribed in pill form. DES also was included in some prenatal vitamins.[citation needed]
In the late 1960s through 1971 a cluster of young women, from their teens into their twenties, was mysteriously diagnosed with clear-cell adenocarcinoma (CCA), a cancer not generally found in women until after menopause. Doctors at Massachusetts General Hospital eventually linked DES exposure before birth to the development of CCA in these young women. They determined the risk for developing CCA among DES daughters is estimated at 1 in a 1,000.[5]
^Smith, Emily K.; White, Mary C.; Weir, Hannah K.; Peipins, Lucy A.; Thompson, Trevor D. (1 January 2012). "Higher incidence of clear cell adenocarcinoma of the cervix and vagina among women born between 1947 and 1971 in the United States". Cancer Causes & Control. SpringerLink. 23 (1): 207–211. doi:10.1007/s10552-011-9855-z. PMC3230753. PMID 22015647.
^(PDF). Centers for Disease Control and Prevention. Archived from the original (PDF) on 4 October 2013. Retrieved 18 June 2013.
^Moyer, Virginia A.; U.S. Preventive Services Task Force (19 June 2012). "Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement". Annals of Internal Medicine. 156 (12): 880–91, W312. doi:10.7326/0003-4819-156-12-201206190-00424. PMID 22711081.
clear, cell, adenocarcinoma, vagina, cervix, rare, adenocarcinoma, often, linked, prenatal, exposure, diethylstilbestrol, drug, which, prescribed, high, risk, pregnancy, cervix, specialtyoncology, gynecology, contents, presentation, diagnosis, treatment, histo. Clear cell adenocarcinoma of the vagina and or cervix is a rare adenocarcinoma often linked to prenatal exposure to diethylstilbestrol DES a drug which was prescribed in high risk pregnancy Clear cell adenocarcinoma of the vagina and or cervix SpecialtyOncology gynecology Contents 1 Presentation 2 Diagnosis 3 Treatment 4 History 5 See also 6 ReferencesPresentation editAfter age 30 it was thought that women exposed prenatally DES daughters were no longer at risk for the disease but as they age into their 40s and 50 cases continue to be reported 1 According to the Centers for Disease Control and Prevention CDC DES daughters should have a pap pelvic exam every year because of their lifelong risk for clear cell adenocarcinoma 2 3 Diagnosis editClear cell adenocarcinoma of the vagina is a rare cancer occurring in up to 10 of primary vaginal malignancies It is all but confirmed if maternal use of DES is established Even though it was once thought to no longer occur past the age of 30 it is still seen in the 40s and 50s Some of the main signs and symptoms for clear cell adenocarcinoma of the vagina are spotting between menstrual cycles bleeding post menopause abnormal bleeding and malignant pericardial effusion or cardiac tamponade 4 Treatment editLow grade cancer is treated by surgical resection High grade will require neoadjuvant chemotherapy and resection Long term surveillance will be required 4 History editThe synthetic estrogen DES was given to millions of pregnant women in the United States and other countries Use in the US was primarily from 1938 to 1971 but not limited to those years Internationally DES use continued until the early 1980s DES was given if a woman had a previous miscarriage diabetes or a pregnancy with bleeding threatened miscarriage or premature labor Up until the mid to late 1950s some women were given DES shots After that DES was primarily prescribed in pill form DES also was included in some prenatal vitamins citation needed In the late 1960s through 1971 a cluster of young women from their teens into their twenties was mysteriously diagnosed with clear cell adenocarcinoma CCA a cancer not generally found in women until after menopause Doctors at Massachusetts General Hospital eventually linked DES exposure before birth to the development of CCA in these young women They determined the risk for developing CCA among DES daughters is estimated at 1 in a 1 000 5 See also editGlassy cell carcinoma of the cervix Vaginal melanomaReferences edit Smith Emily K White Mary C Weir Hannah K Peipins Lucy A Thompson Trevor D 1 January 2012 Higher incidence of clear cell adenocarcinoma of the cervix and vagina among women born between 1947 and 1971 in the United States Cancer Causes amp Control SpringerLink 23 1 207 211 doi 10 1007 s10552 011 9855 z PMC 3230753 PMID 22015647 Annual Exam for DES Daughters PDF Centers for Disease Control and Prevention Archived from the original PDF on 4 October 2013 Retrieved 18 June 2013 Moyer Virginia A U S Preventive Services Task Force 19 June 2012 Screening for Cervical Cancer U S Preventive Services Task Force Recommendation Statement Annals of Internal Medicine 156 12 880 91 W312 doi 10 7326 0003 4819 156 12 201206190 00424 PMID 22711081 a b Gera S Clear cell adenocarcinoma PathologyOutlines com website http www pathologyoutlines com topic vaginaclearcelladeno html Accessed May 25th 2019 Hatch EE Palmer JR Titus Ernstoff L et al August 1998 Cancer risk in women exposed to diethylstilbestrol in utero JAMA 280 7 630 4 doi 10 1001 jama 280 7 630 PMID 9718055 nbsp This article incorporates public domain material from Dictionary of Cancer Terms U S National Cancer Institute Retrieved from https en wikipedia org w index php title Clear cell adenocarcinoma of the vagina amp oldid 1185397535, wikipedia, wiki, book, books, library,
