Authors : Anshul Singh, Shatakshee Tewari, Satyam , Kachnar Varma, Vatsala Misra
DOI : 10.18231/j.achr.2020.021
Volume : 5
Issue : 1
Year : 2020
Page No : 104-108
Introduction: Adenocarcinomas of clear cell type are uncommon tumors accounting for 5-10% of all
vaginal tumours which in turn account for approximately 2% of all gynaecologic malignancies. Though
Clear cell Adenocarcinomas arising in the setting of previous Di-Ethyl–Stilbesterol [DES] exposure have
been reported quite often, only few cases of these not associated with DES have been documented.
Amongst non-DES exposed patients, CCAs are said to be sporadic or in association with endometriosis in
women of peri/postmenopausal age or in association with some congenital genitourinary anomalies mostly
affecting young females.
Case Report: A 16 year old female presented with heavy bleeding per vaginum since 2 months. On per
vaginal examination a polypoidal mass was felt on posterior wall of vagina. Ultrasonography revealed
the presence of a uterus didelphys in addition to this mass. Polypectomy was done. On microscopy, a
diagnosis of clear cell adenocarcinoma was made which was confirmed on immunohistochemistry. There
was no history of any DES exposure in the mother.
Conclusion: We present here a case of an adolescent female with uterus didelphys and no DES exposure
who was diagnosed as a case of Vaginal Clear cell Adenocarcinoma. The rarity of this tumour among DESexposed
cases and its presence in non-exposed patients warrants a more thorough search for the underlying
pathology.
Keywords: Mesonephric carcinoma, Genitourinary malformations, Non diethylstilbestrol, Tumours of adolescent females.