Non-diethylstilbestrol exposed vaginal adenocarcinoma in young patients associated with unilateral renal agenesis: two case reports and literature review

Adenocarcinoma, accounts for up to 14% of all vaginal cancer. In young patients, common histological feature is clear cell adenocarcinoma (CCA) while mesonephric adenocarcinoma (MA) is very rare. The authors report two patients in their early twenties with unilateral renal agenesis and vaginal adeno...

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Bibliographic Details
Published in:European journal of gynaecological oncology 2017, Vol.38 (1), p.157-161
Main Authors: Plesinac-Karapandzic, V, Stojanovic Rundic, S, Jankovic, R, Nadrljanski, M, Milovanovic, Z, Tomasevic, A, Perisie Jeremic, N
Format: Article
Language:English
Subjects:
Adenocarcinoma - complications
Adenocarcinoma - diagnosis
Adenocarcinoma - therapy
Adult
Diethylstilbestrol
Estrogens, Non-Steroidal
Female
Humans
Solitary Kidney - complications
Vaginal Neoplasms - complications
Vaginal Neoplasms - diagnosis
Vaginal Neoplasms - therapy
Young Adult
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Summary:Adenocarcinoma, accounts for up to 14% of all vaginal cancer. In young patients, common histological feature is clear cell adenocarcinoma (CCA) while mesonephric adenocarcinoma (MA) is very rare. The authors report two patients in their early twenties with unilateral renal agenesis and vaginal adenocarcinoma not exposed to diethylstilbestrol (DES). Two patients with vaginal adenocarcinoma were treated, with external beam radiotherapy of pelvis combined with brachytherapy to a radical dose. In 2000, 25-year-old female, was admitted for radiotherapy after incomplete excision of the tumor localized in left vaginal apex and fornix. Histopathology confirmed CCA and classified as clinical Stage II. CT revealed left renal agenesis.The patient is alive and disease-free 15 years after therapy. Vaginal, urethral stenosis, and hydronephrosis occurred and ureteral stent was inserted. In the second patient, 22-year-old, in 2004, after biopsy of bulky tumor of vagina and histology, revealed MA in Stage III and CT scan also confirmed right renal agenesis. Radiotherapy was followed by chemotherapy. After 11 years, patient is disease-free with vaginal stenosis and incipient renal hydronephrosis. Radiotherapy is effective treatment in advance vaginal adenocarcinoma, however, with high morbidity. The authors advise rigorous gynecologic exams in young females with renal agenesis as there may be a risk of malignant changes in vagina.
ISSN:0392-2936
DOI:10.12892/ejgo3323.2017