Difference between revisions of "Clear cell carcinoma of the uterine cervix"

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#redirect [[Uterine_cervix#Clear_cell_carcinoma_of_the_uterine_cervix]]
'''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]]

Revision as of 13:42, 24 April 2014

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.[1]
  • Less common in the cervix - when compared to other gynecologic sites.[2]
  • Typical young women - median age ~38 in one series.[4]

Note:

  • HPV does not appear to be important in the oncogenesis;[5] however, this is not completely settled.[6]

Microscopic

Features:[6]

  • 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:

IHC

See also

References

  1. ↑ van Dijck, JA.; Doorduijn, Y.; Bulten, JH.; Verloop, J.; Massuger, LF.; Kiemeney, BA. (2009). "[Vaginal and cervical cancer due to diethylstilbestrol (DES); end epidemic]". Ned Tijdschr Geneeskd 153: A366. PMID 19857300.
  2. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 442. ISBN 978-0781765275.
  3. ↑ Babić, D.; Kos, M.; Jukić, S.; Ilić, J.; Vecek, N.; Kos, M.; Mahnik, N.. "[Clear cell carcinoma of the female genital tract].". Jugosl Ginekol Perinatol 31 (3-4): 102-4. PMID 1749271.
  4. ↑ Jiang, X.; Jin, Y.; Li, Y.; Huang, HF.; Wu, M.; Shen, K.; Pan, LY. (2014). "Clear cell carcinoma of the uterine cervix: clinical characteristics and feasibility of fertility-preserving treatment.". Onco Targets Ther 7: 111-6. doi:10.2147/OTT.S53204. PMID 24470762.
  5. ↑ Kocken, M.; Baalbergen, A.; Snijders, PJ.; Bulten, J.; Quint, WG.; Smedts, F.; Meijer, CJ.; Helmerhorst, TJ. (Aug 2011). "High-risk human papillomavirus seems not involved in DES-related and of limited importance in nonDES related clear-cell carcinoma of the cervix.". Gynecol Oncol 122 (2): 297-302. doi:10.1016/j.ygyno.2011.05.002. PMID 21620450.
  6. ↑ 6.0 6.1 6.2 6.3 Offman, SL.; Longacre, TA. (Sep 2012). "Clear cell carcinoma of the female genital tract (not everything is as clear as it seems).". Adv Anat Pathol 19 (5): 296-312. doi:10.1097/PAP.0b013e31826663b1. PMID 22885379.
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