Very late recurrence of DES-related clear cell carcinoma of the cervix

Long term surveillance of DES exposed women is a must

image of clear-cell-carcinoma-of-the-cervix
This 2015 case demonstrates the need and the importance for continued and frequent follow-up examination in individuals prenatally exposed to diethylstilbestrol.

2015 Study Abstract

Clear cell adenocarcinoma of the cervix is a rare tumor of the lower genital tract. It has been described in young women with a history of intra uterine exposure to diethylstilbestrol. This tumor is characterized by a greater tendency for late recurrences. In this article, we report the case of one exposed-patient who developed recurrence as liver metastases, 24 years after the initial treatment. This case demonstrates the need and the importance for continued follow-up in individuals prenatally exposed to diethylstilbestrol.

2015 Study Conclusions

To summarize, this case represents the longest reported disease-free interval till recurrence and the first description of metastatic liver disease of DES related clear cell adenocarcinoma of the cervix. It reemphasizes the necessity of long term surveillance of DES exposed women and confirms previous reports recommending the importance of frequent follow-up examination not only of the pelvis but also of all distant potential sites of metastasis. It also shows that treatment with paclitaxel, carboplatin and bevacizumab can be an effective and safe therapeutic option for treating recurrence of this rare tumor.

Sources and more information
  • Very late recurrence of Diethylstilbestrol – related clear cell carcinoma of the cervix: case report,Ablavi Adani-Ifè, Emma Goldschmidt, Pasquale Innominato, Ayhan Ulusakarya, Hassan Errihani, Philippe Bertheau and Jean François Morère, Gynecologic Oncology Research and Practice 2015, $article.volume.volumeNumber:3 doi:10.1186/s40661-015-0010-5, gynoncrp.com/content/2/1/3, 17 July 2015.
  • Gynecologic Oncology Research and Practice PDF case report.
More DES DiEthylStilbestrol Resources

4 thoughts on “Very late recurrence of DES-related clear cell carcinoma of the cervix”

  1. Having reached the ripe age of 63 my male physician declared that he was not certain if I should continue to have annual paps even though I am a DES daughter. He has referred me to a Woman’s Health Care Center at St Mary’s in Richmond, VA. I was told just last year that after I reached the age 60 I only required a pap once every five year, though when I reminded him to check my chart, that I was a DES daughter he immediately processed me through. According to him, he knew very little about the use of the drug and I was only the second female he had met that been exposed to the DES during my Mother’s pregnancy. Would you please guide me to a reputable web site where I might read up on what the recommended age is to stop and/or slow down the annual exams. I might also add that he stated that at ‘my age’ there was little chance of me contracting a sexually transmitted disease because he assumed my activity was almost non-existent. To which I rolled my eyes and shook my head.
    Sidebar: at the age of nine [1961] my Mother took me to a doctor who advised her that my cervical walls had already started to crumble.

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