Department of Obstetrics and Gynecology, University of Medicine and Pharmacy 'Grigore T. Popa', 700115 Iasi, Romania.
Department of Morpho-Functional Sciences I-Histology, Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Int J Environ Res Public Health. 2022 Dec 11;19(24):16652. doi: 10.3390/ijerph192416652.
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.
宫颈癌在青少年和儿科人群中较为罕见，其中腺癌最为常见。子宫颈透明细胞腺癌仅占所有腺癌病例的 4%，约三分之二与宫内己烯雌酚（DES）暴露有关。我们报告了一例 14 岁的处女女孩，她因阴道出血和下腹痛持续 1 个月而就诊。经腹盆腔超声检查显示宫颈有一个大小为 7cm 的不规则、均匀的肿块。因此，进行了磁共振成像（MRI）扫描以确定肿瘤的起源及其与相邻盆腔器官的关系。此外，还进行了阴道镜检查以识别肿瘤，并进行了宫颈活检。免疫组化和解剖病理学研究诊断为非 HPV（人乳头瘤病毒）相关的宫颈透明细胞腺癌。在进行肿瘤学检查后，她接受了放疗。患者的母亲在宫内没有 DES 暴露史。尽管文献中的病例数量较少，但大多数被诊断为宫颈透明细胞腺癌的处女女孩由于诊断延误，预后较差。
