Clear Cell Adenocarcinoma of the Ovary Associated with In Utero DES Exposure

A 45-year-old white woman was referred to an outpatient clinic with a self-discovered lump in the left lower abdominal quadrant


To our knowledge, this patient is the first clinical case featuring clear cell adenocarcinoma of the ovary that may be linked to diethylstilbestrol exposure in utero. We would like to emphasize that clear cell adenocarcinoma of the vagina and cervix, not the ovary, were previously shown to be sites for tumors in female offspring exposed prenatally to DES.

A 45-year-old woman presented with a self-discovered lump in the lower abdominal quadrant. She underwent surgery and staging that revealed clear cell adenocarcinoma confined to the left ovary. Foci of high-grade squamous neoplastic proliferation, inflammation, and a paratubal cyst were also present on the pathology specimen. Medical records established unequivocally that the patient’s mother received diethylstilbestrol therapy throughout the pregnancy. since clear cell cancers can develop, not infrequently, in foci of endometriosis, our patient’s pathology specimen was carefully inspected for endometriosis and none was found. Moreover, evidence linking prenatal DES exposure with chronic ovarian inflammation, paraovarian cysts, and high-grade squamous neoplastic proliferation in the genital tract has been accumulating. Although our patient is older than most patients in the Herbst cohort and a sporadic case of clear cell carcinoma cannot be excluded with certainty, all of the above changes were present in our patient’s pathology specimen. This further enhances our degree of suspicion on the causality between in utero DES exposure and the clear cell adenocarcinoma of the ovary in our patient.

Clear Cell Adenocarcinoma of the Ovary Associated With In Utero Diethylstilbestrol Exposure: Case Report and Clinical Overview, Medscape J Medv.11(1); 2009PMC2654676, 2009 Jan 7.

Our case is consistent with clear cell adenocarcinoma, probably related to diethylstilbestrol exposure in utero. Our case of probable DES-induced transplacental carcinogenesis more than 4 four decades after exposure reinforces the need for continued vigilance and routine gynecologic examinations in individuals prenatally exposed to this drug.

More DES DiEthylStilbestrol Resources

2 thoughts on “Clear Cell Adenocarcinoma of the Ovary Associated with In Utero DES Exposure”

  1. I was diagnosed with cervical clear cell adenocarcinoma at age 22 (Spring 2012). My mother is a DES daughter. How many other DES daughters have found that their daughters also end up with Clear Cell Adenocarcinoma? Are there any studies documenting this? I know my gyn-oncologist told me this was a trend he had begun to notice – he’s located in Pittsburgh, PA (USA).

    1. Hi Laura and very sorry to hear about your health issues.
      I don’t know how many grand daughters are affected with CCAC.
      If you scroll this page you will see CCAC related studies.
      I will still add studies as I find them and researchers only start to publish studies on DES effects in 3rd generation.
      It is probably still early to find documentation online.

      A fantastic resource is pubmed then you will need to trim via adding more keywords in the search.
      But for example this new study published last week, is about the 2nd generation, not the 3rd…

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