Korean J Obstet Gynecol.  2010 Apr;53(4):371-376. 10.5468/kjog.2010.53.4.371.

A case of clear cell carcinoma of uterine cervix not related to intrauterine dietylstilbesterol exposure

Affiliations
  • 1Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Korea. rohjuwon@dumc.or.kr
  • 2Department of Pathology, Dongguk University Ilsan Hospital, Goyang, Korea.

Abstract

Clear cell carcinoma of the uterine cervix is rare cancer that accounts for 4 to 9% of the adenocarcinoma of uterine cervix. Although intrauterine exposure to diethylstilbestrol (DES) during early pregnancy is one of the established risk factors, DES exposure may not be confirmed in all patients. We experienced a case of clear cell carcinoma in the uterine cervix of 67-year-old woman who was not exposed to DES. She was initially diagnosed as endometrial clear cell carcinoma because of the normal colposcopic finding and histologically proven clear cell carcinoma from endometrial aspiration biopsy and endocervical curettage. We performed a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and lymphadnectomy including both pelvic and para-aortic regions. On the final pathologic diagnosis of clear cell carcinoma confined to endocervix, the patient was received adjuvant concurrent chemoradiation with weekly cisplatin. We present the case with a brief review of related literature.

Keyword

Clear cell carcinoma; Cervical carcinoma; Diethylstilbestrol

MeSH Terms

Adenocarcinoma
Aged
Biopsy, Needle
Cervix Uteri
Cisplatin
Curettage
Diethylstilbestrol
Female
Humans
Hysterectomy
Pregnancy
Risk Factors
Cisplatin
Diethylstilbestrol

Figure

  • Fig. 1 Pre-operative pelvic magnetic resonance imaging (T2WI) showed a mass with 10 mm diameter, low signal density in lower posterior endometrial wall (white circle). There was no evidence of extension into parametrium or metastatic lymphadenopathy.

  • Fig. 2 Pathologic features of clear cell carcinoma of the cervix. Infiltrating tumor cells with tubule-cystic growth pattern are visible in the cervical stroma. Tumor cells with clear cytoplasm often project into the lumen of the cysts and tubules to form 'hobnail appearance' (H&E stain, ×200).


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