Vaginal cancer is generally a rare disease but the number of cases increased in number in the 1960s, prompting gynecologists and ultimately federal officials to review its connection to DES (diethylstilbestrol) usage. Cervical cancer is far more common, approximately 20,000 cases per year and the diagnosis has become much easier with the advent of the Pap smear. Both of these cancers are of the squamous cell type. DES causes an unusual variant of either called clear cell adenocarcinoma (2), or glandular cancer.
A diagnosis of adenocarcinoma of the vagina or cervix should always demand an investigation for possible DES usage by the patient's mother. DES attorneys have the necessary experience to determine the appropriate handling of this unfortunate circumstance. Please review some of the medical literature on this subject.
A highly unusual variant; not normally seen without DES exposure. Herbst (2), in a pivotal paper, described the initial association of clear cell adenocarcinoma of the vagina in the daughters of women who took DES during pregnancy (DES daughters). This paper was instrumental in convincing the federal government to order the removal of DES from the market and initiated the initial wave of DES litigation.
By 1979, after review of several cancer registries and several studies, the information showed a causal relationship between prenatal DES exposure in the first trimester of pregnancy and vaginal/cervical clear cell adenocarcinoma. A recent report by Vang et al. recently highlighted 3 cases of a pseudoinfiltrative tubal metaplasia of the endocervix (glandular proliferation and invasion) that can closely mimic endocervical adenocarcinoma (3).
2. Herbst A.L., Ulfelder H, Poskanzer D.C: Adenocarcinoma of the Vagina: Association of Maternal Stilbestrol therapy with Tumor Appearance in Young Women. N Engl J Med 1971; 284: 878-881.
3. Vang R. et al. Pseudoinfiltrative Tubal Metaplasia of the Endocervix: A Potential Form of In Utero Diethylstilbestrol Exposure-Related Adenosis Simulating Minimal Deviation Adenocarcinoma. International Journal of Gynecological Pathology. 24:391-398, October 2005.