Case Report

Clear Cell Adenocarcinoma of Vagina during the Pregnancy: A Case Report

  • Talat Umut Kutlu Dilek
  • Ilay Öztürk
  • Özlem Pata
  • Tuba Karabacak
  • Filiz Çayan
  • Saffet Dilek

Received Date: 15.01.2007 Accepted Date: 17.04.2007 J Turk Ger Gynecol Assoc 2007;8(2):215-217

Vaginal clear cell carcinoma is very rare during the pregnancy. A 31-year-old woman was admitted by persistent vaginal bleeding at 28th weeks of gestation. On pelvic examination, fragile and hemorrhagic mass was detected a 6 by 7 cm mass on anterior vaginal wall adjacent to bladder trigone. Biopsy of the lesion demonstrated clear cell adenocarcinoma of vagina. She has no history for the prenatal exposure to DES. Treatment was postponed to 31 week’s of gestation to achieve lung maturity of fetus and preoperative work-up. She underwent surgical staging following the delivery by cesarean section at 31 week’s of gestation. Preoperative diagnosis was confirmed postoperatively and two metastatic pelvic lymph nodes were detected. She refused postoperative adjuvant radiotherapy. She died at postoperative 6th month due to distant metastasis. However, majority of antenatal bleedings were related to obstetrical causes, lower genital tract malignancies should be excluded by basic gynecologic examination and cervical smear screening. Turkish Gebelikte Vajenin Berrak Hücreli Adenokarsinomu: Olgu Sunumu Gebelik sirasinda vajinal berrak hücreli kanser çok nadirdir. Intrauterin DES maruziyeti olmayan, 31 yasinda, 28 haftalik gebe olan hasta, inatçi vajinal kanama sikayeti ile basvurdu. Yapilan pelvik muayenede; mesane trigonuna komsu, 6-7 cm çapinda, frajil kanamali kitle saptandi. Biyopsi sonucu berrak hücreli vajinal adenokanser olarak rapor edildi. Fetusun akciger matürasyonun ve yenidogan yogun bakim kosullarinin saglanmasi için tedavi 31. gebelik haftasina kadar ertelendi. Otuzbirinci gebelik haftasinda, olgunun sezaryenle dogumunun gerçeklestirilmesini takiben cerrahi evreleme yapildi. Preoperatif tani, operasyon spesmeninde konfirme edildi ve 2 adet pelvik lenf nodunda metastaz saptandi. Adjuvan radyoterapiyi reddeden hasta, postoperatif 6. ayda metastatik hastalik nedeni ile kaybedildi. Antenatal kanamalarin büyük bir kismi obstetrik nedenlere bagli olarak ortaya çiksa da basit bir pelvik muayene ve servikal smear ile asagi genital kanal maligniteleri kolaylikla dislanabilir.

Keywords: Pregnancy, vaginal cancer, clear cell adenocarcinoma, antenatal bleeding