The presence of glandular cells in the vagina of hysterectomized women can have several origins. These cells may undergo malignant changes and thus give rise to primary adenocarcinoma of the vagina. This kind of neoplasia is rare and the most common risk factor for its development is the intrauterine exposure to diethylstilbestrol.We report the case of a 70 year old patient with clinical history of hysterectomy at the age of 36 to control bleeding after miscarriage. A mass in the anterior wall of the vagina was detected by ultrasound examination. Vaginal cytology showed atypical glandular cells with features of adenocarcinoma, not otherwise specified. The subsequent biopsy showed a vaginal adenocarcinoma.There was no clinical information about possible intrauterine exposure to diethylstilbestrol.
The presence of endometrial cells is considered an alarming finding in gynecological smears of women in the second half of the menstrual cycle or after the age of 45 years. In particular, in postmenopausal women, the presence of atypical endometrial cells may represent a serious uterine pathology and requires a thorough evaluation.We report a case of a 77 year post-menopausal woman, who presented with vaginal bleeding without ecographic uterine alterations. Cervicovaginal cytology revealed the presence of abnormal endometrial cells in clusters, unusual in the clinical context of the woman. The cytological result was atypical glandular cells, favor neoplastic. Based on this result, the patient was submitted to an endometrial curettage, which was diagnosed as carcinosarcoma, and with a radical hysterectomy.Although the cytological result was not in accordance with the histological diagnosis, it indicates the necessity of studying the endometrium and the subsequent diagnosis of carcinosarcoma.
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