Primary Clear Cell Adenocarcinoma of the Uterine Cervix in a 14-Year-Old Virgin Girl: Case Report

Int J Environ Res Public Health. 2022 Dec 11;19(24):16652. doi: 10.3390/ijerph192416652.

Abstract

Cervical cancer is rare in adolescent and pediatric populations, with adenocarcinoma being the most commonly reported. Clear cell adenocarcinoma of the uterine cervix accounts for only 4% of all adenocarcinoma cases, and about two-thirds are associated with intrauterine diethylstilbestrol (DES) exposure. We report the case of a 14-year-old virgin girl who presented with a 1-month-long history of abnormal vaginal bleeding and lower abdominal pain. Transabdominal pelvic ultrasound examination revealed the presence of an irregular, homogeneous cervical mass that was 7 cm in size. Therefore, a magnetic resonance imaging (MRI) scan was performed to establish the origin of the tumor and its relationship to adjacent pelvic organs. Furthermore, a vaginoscopy was performed to identify the tumor, and a cervical biopsy was performed. Immunohistochemical and anatomopathological studies resulted in the diagnosis of non-HPV(Human Papilloma Virus)-related clear cell adenocarcinoma of the cervix. Following the oncological examination, she was admitted for radiotherapy. The patient had no maternal history of DES exposure in utero. Even though the number of cases in the literature is low, most of the virgin girls diagnosed with clear cell adenocarcinoma of the cervix have a fatal prognosis because of the delay in making a correct diagnosis.

Keywords: chemotherapy; clear cell adenocarcinoma; diethylstilbestrol; immunohistochemical; intracavitary brachytherapy; non-HPV; radiotherapy; virgin girl.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Clear Cell* / diagnosis
  • Adenocarcinoma, Clear Cell* / pathology
  • Adolescent
  • Cervix Uteri / pathology
  • Child
  • Diethylstilbestrol
  • Female
  • Human Papillomavirus Viruses
  • Humans
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / pathology
  • Vagina / pathology

Substances

  • Diethylstilbestrol

Grants and funding

This research received no external funding.