A Rare Case of Clear Cell Cervical Carcinoma to a Woman, 50 Years After Diethylstilbestrol Exposure for Lactation Suppression

Palaiologos, Konstantinos; Theofrastou, Stratos S.; Gerovasileiou, Effrosuni; Flynn, Marina

doi:10.7759/cureus.17468

Cureus

2021

DOI: 10.7759/cureus.17468

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A Rare Case of Clear Cell Cervical Carcinoma to a Woman, 50 Years After Diethylstilbestrol Exposure for Lactation Suppression

Konstantinos Palaiologos

Stratos S. Theofrastou

Effrosuni Gerovasileiou

et al.

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2022

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“…10 Despite these recommendations, DES-related malignancies are rare after menopause, with only a few cases reported. [12][13][14] Currently, most of the population exposed to DES in utero is 60 years and older. The goal of this study is to examine the incidence of DES-related cervical and vaginal cancer in women 50 years and older.…”

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Postmenopausal Vaginal and Cervical Cancer Risk Related to In Utero Diethylstilbestrol Exposure

Wamakima

McKinney

Bookman

et al. 2022

J Low Genit Tract Dis

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ObjectivesWomen exposed to diethylstilbestrol (DES) in utero have an increased risk of clear cell adenocarcinoma of the lower genital tract, requiring lifelong cervical and vaginal cancer screening. We examined the incidence of DES-related cancers in postmenopausal women 50 years and older.Materials and MethodsWe conducted a retrospective chart review of patients 50 years and older exposed to DES in utero who received care at our institution. Patients were identified using billing codes and/or searching through the electronic record for the word DES. With this 2-pronged approach, we reviewed a total of 503 charts with confirmed DES exposure to identify gynecologic cancer occurrence.ResultsWithin the 503 selected charts, 28 cases of gynecologic cancer occurrence were identified. Ten patients had cervical cancer and one patient had vaginal cancer. Only 1 woman of 503 developed a DES-related cervical or vaginal malignancy after age 50 years. No patients were diagnosed with cervical or vaginal cancer after age 65 years.ConclusionsDiethylstilbestrol-related malignancies are rare in those older than 50 years. Current cervical cancer screening guidelines recommend cessation of screening in an average risk, adequately screened patient at age 65 years, but patients exposed to DES have historically received lifelong screening. However, we found no cases of cervical or vaginal cancer related to DES after age 65 years, suggesting that screening recommendations could be changed for these patients to align with current screening guidelines.

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“…Instead, current guidelines recommend lifetime annual vaginal and cervical cytology for this population 10 . Despite these recommendations, DES-related malignancies are rare after menopause, with only a few cases reported 12–14 …”

mentioning

confidence: 99%

Postmenopausal Vaginal and Cervical Cancer Risk Related to In Utero Diethylstilbestrol Exposure

Wamakima

McKinney

Bookman

et al. 2022

J Low Genit Tract Dis

View full text Add to dashboard Cite

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A Rare Case of Clear Cell Cervical Carcinoma to a Woman, 50 Years After Diethylstilbestrol Exposure for Lactation Suppression

Cited by 1 publication

References 18 publications

Postmenopausal Vaginal and Cervical Cancer Risk Related to In Utero Diethylstilbestrol Exposure

Postmenopausal Vaginal and Cervical Cancer Risk Related to In Utero Diethylstilbestrol Exposure

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