J Korean Soc Radiol.  2013 Oct;69(4):321-325. 10.3348/jksr.2013.69.4.321.

Clear Cell Adenocarcinoma of the Uterine Cervix in a 15-Year-Old Girl: A Case Report

• Choi SJ
• Kim JE
• Kim HS
• Choi HY

• KMID: 2041955
• DOI: http://doi.org/10.3348/jksr.2013.69.4.321

Abstract

Cervical cancer is rare in the pediatric population. In cases of cervical cancer, adenocarcinoma is predominantly reported. Clear cell adenocarcinoma (CCAC) of the uterine cervix is a very rare tumor and accounts for only 4% of all adenocarcinomas of the uterine cervix. Risk factors and pathogenesis of this disease are not exactly revealed. The intrauterine exposure to diethylstilbestrol (DES) and associated non-steroidal estrogen during pregnancy before 18 weeks is the only known risk factor. This study reports the imaging finding of primary uterine cervical tumor in a 15-year-old girl, who was finally diagnosed with CCAC, with no maternal history of DES exposure in utero.

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Clear Cell
Adolescent
Cervix Uteri
Diethylstilbestrol
Estrogens
Female
Humans
Pregnancy
Risk Factors
Uterine Cervical Neoplasms
Diethylstilbestrol
Estrogens

Figure

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  Fig. 1 A 15-year-old adolescent with clear cell adenocarcinoma of the cervix. Axial transrectal pelvic ultrasonograph shows a 7 × 3 cm well defined homogeneous intermediate echoic mass in the upper vagina and cervix.

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  Fig. 2 Axial contrast-enhanced CT image demonstrates a 7 × 4 cm well defined homogeneous, enhancing mass in the upper vagina and cervix.

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  Fig. 3 Axial (A) and sagittal (B) T2-weighted images show a lobulated homogeneous, hyperintense mass in the upper vagina and cervix. No parametrial extension is evident and interfaces between the mass, bladder, and rectum are sharply delineated without evidence of tumor invasion. (C) Non-contrast axial T1-weighted image shows an isointense mass versus myometrium. (D) Gadolinium enhanced axial T1-weighted image shows a homogeneous, well-enhanced mass.

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  Fig. 4 A. F-18 fluorodeoxyglucose positron emission tomography/CT image shows hypermetabolic changes in the upper vagina and cervix (arrow). B. Hypermetabolic change in right common iliac and left external iliac area is noted (arrows).

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  Fig. 5 Pathologic features of clear cell adenocarcinoma of the cervix. Photomicrograph shows infiltrating tumor cells with a tubular-cystic growth pattern in cervical stroma. Tumor cells with clear cytoplasm often project into the lumen of cysts and tubules with a 'hobnail appearance'. A. H&E, × 40. B. H&E, × 200.

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