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Difference between revisions of "Clear cell carcinoma of the uterine cervix"
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Clear cell carcinoma of the uterine cervix (view source)
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'''Clear cell carcinoma of the uterine cervix''' is a rare malignancy of the [[uterine cervix]] that classically is associated with DES exposure. It typically occurs in younger women. | |||
*[[AKA]] ''cervical clear cell carcinoma''. | |||
==General== | |||
*Associated with ''diethylstilbestrol'' exposure ''in utero''.<ref name=pmid19857300>{{Cite journal | last1 = van Dijck | first1 = JA. | last2 = Doorduijn | first2 = Y. | last3 = Bulten | first3 = JH. | last4 = Verloop | first4 = J. | last5 = Massuger | first5 = LF. | last6 = Kiemeney | first6 = BA. | title = [Vaginal and cervical cancer due to diethylstilbestrol (DES); end epidemic] | journal = Ned Tijdschr Geneeskd | volume = 153 | issue = | pages = A366 | month = | year = 2009 | doi = | PMID = 19857300 }}</ref> | |||
*Less common in the cervix - when compared to other gynecologic sites.<ref name=Ref_WMSP442>{{Ref WMSP|442}}</ref> | |||
**More common in the [[clear cell carcinoma of the endometrium|endometrium]].<ref>{{Cite journal | last1 = Babić | first1 = D. | last2 = Kos | first2 = M. | last3 = Jukić | first3 = S. | last4 = Ilić | first4 = J. | last5 = Vecek | first5 = N. | last6 = Kos | first6 = M. | last7 = Mahnik | first7 = N. | title = [Clear cell carcinoma of the female genital tract]. | journal = Jugosl Ginekol Perinatol | volume = 31 | issue = 3-4 | pages = 102-4 | month = | year = | doi = | PMID = 1749271 }}</ref> | |||
*Typical young women - median age ~38 in one series.<ref name=pmid24470762>{{Cite journal | last1 = Jiang | first1 = X. | last2 = Jin | first2 = Y. | last3 = Li | first3 = Y. | last4 = Huang | first4 = HF. | last5 = Wu | first5 = M. | last6 = Shen | first6 = K. | last7 = Pan | first7 = LY. | title = Clear cell carcinoma of the uterine cervix: clinical characteristics and feasibility of fertility-preserving treatment. | journal = Onco Targets Ther | volume = 7 | issue = | pages = 111-6 | month = | year = 2014 | doi = 10.2147/OTT.S53204 | PMID = 24470762 }}</ref> | |||
Note: | |||
*[[HPV]] does '''not''' appear to be important in the oncogenesis;<ref name=pmid21620450>{{Cite journal | last1 = Kocken | first1 = M. | last2 = Baalbergen | first2 = A. | last3 = Snijders | first3 = PJ. | last4 = Bulten | first4 = J. | last5 = Quint | first5 = WG. | last6 = Smedts | first6 = F. | last7 = Meijer | first7 = CJ. | last8 = Helmerhorst | first8 = TJ. | title = High-risk human papillomavirus seems not involved in DES-related and of limited importance in nonDES related clear-cell carcinoma of the cervix. | journal = Gynecol Oncol | volume = 122 | issue = 2 | pages = 297-302 | month = Aug | year = 2011 | doi = 10.1016/j.ygyno.2011.05.002 | PMID = 21620450 }}</ref> however, this is not completely settled.<ref name=pmid22885379/> | |||
==Microscopic== | |||
Features:<ref name=pmid22885379/> | |||
*Like [[clear cell carcinoma]] elsewhere: | |||
**Clear cytoplasm - '''key feature'''. | |||
***May be absent! | |||
**Cells have large free/luminal surface area (hobnailing pattern) and small non-free surface. | |||
**Moderate-to-severe [[nuclear pleomorphism]]. | |||
**Tubular and/or cystic morphology. | |||
***May be (simple) papillary and/or solid. | |||
*Adenosis - typically adjacent. | |||
DDx: | |||
*[[Clear cell carcinoma of the endometrium]] - diagnosis based on clinico-radiologic correlation (IHC & histology not useful).<ref name=pmid22885379>{{Cite journal | last1 = Offman | first1 = SL. | last2 = Longacre | first2 = TA. | title = Clear cell carcinoma of the female genital tract (not everything is as clear as it seems). | journal = Adv Anat Pathol | volume = 19 | issue = 5 | pages = 296-312 | month = Sep | year = 2012 | doi = 10.1097/PAP.0b013e31826663b1 | PMID = 22885379 }}</ref> | |||
*[[Serous carcinoma of the endometrium]]. | |||
*[[Serous carcinoma of the uterine cervix]]. | |||
==IHC== | |||
*Essentially considered to be like ''[[endometrial clear cell carcinoma]]''.<ref name=pmid22885379/> | |||
==See also== | |||
*[[Uterine cervix]]. | |||
*[[Clear cell carcinoma]]. | |||
*[[Clear cell carcinoma of the vagina]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Uterine cervix]] | |||