Ott M M, Rehn M, Müller J G, Gruss A, Martius J, Steck T, Müller-Hermelink H K
Institute of Pathology, University of Würzburg, Germany.
Virchows Arch. 1994;425(4):445-8. doi: 10.1007/BF00189584.
The association of clear cell adenocarcinoma of the vagina and vaginal adenosis with prenatal exposure to diethylstilbestrol (DES) is well-documented in the United States. In Europe, however, DES was never used in the therapy of threatened abortion and, therefore, clear cell adenocarcinoma and vaginal adenosis remained rare diseases. We report on the clinical and pathological features of a case of clear cell adenocarcinoma of the upper vagina in a 17-year-old German girl, who had a history of hypoplasia of the left kidney with an ectopic termination of the ureter in the upper vagina, removed surgically 2 years before. No previous report of a similar coincidence of vaginal clear cell carcinoma and a congenital disorder of the genitourinary tract exists. Congenital anomaly of the ureter interfering with the development and the differentiation of the distal Müllerian tract and its epithelium might have provided a similar histological basis for carcinogenesis in our patient to that in those provided exposed to DES.
在美国，阴道透明细胞腺癌及阴道腺病与产前暴露于己烯雌酚（DES）之间的关联已有充分记录。然而在欧洲，DES从未用于先兆流产的治疗，因此，透明细胞腺癌和阴道腺病仍然是罕见疾病。我们报告了一名17岁德国女孩的上阴道透明细胞腺癌病例的临床和病理特征，该女孩有左肾发育不全病史，输尿管异位终止于上阴道，两年前已手术切除。此前尚无阴道透明细胞癌与泌尿生殖道先天性疾病类似巧合情况的报告。输尿管先天性异常干扰了远端苗勒管及其上皮的发育和分化，这可能为我们患者的致癌作用提供了与DES暴露患者相似的组织学基础。
