Clear Cell Carcinoma of the Cervix

Excerpt

Clear cell carcinoma of the uterine cervix is a rare and highly invasive variant of adenocarcinoma and accounts for 4% of all cervical adenocarcinomas. Although this condition has been historically associated with in-utero exposure to diethylstilbestrol (DES), cases of clear cell adenocarcinoma have been reported in both adult women and children without this exposure. Of note, there is a higher incidence of late-stage (stage III and IV) disease in the pediatric population when compared to adult patients in whom this condition is diagnosed. Patients often present to their physician with abnormal vaginal bleeding (premenarchal, intermenstrual, postcoital, postmenopausal), abnormal vaginal discharge, abdominal pain, or lower extremity edema.

The diagnosis of clear cell carcinoma of the uterine cervix is mainly established based on histopathological examination of biopsy-obtained specimens. Histologically, clear cell carcinoma of the uterine cervix is predominantly composed of clear or hobnail cells whose architectural patterns are mixed with solid and tubulocystic patterned areas, mainly composed of nests of cells with clear eosinophilic cytoplasm and hyperchromatic nuclei. Treatment is dependent upon the stage at diagnosis and patients’ desires to preserve fertility and can include a combination of surgical, radiation, and chemotherapeutic options.