Diethylstilbestrol (DES)-induced clear cell adenocarcinoma of the vagina metastasizing to the brain

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Primary vaginal clear cell adenocarcinoma (CCA) is a rare gynecological malignancy occurring predominantly in young females with a history of diethylstilbestrol exposure in utero. Vaginal CCA commonly metastasizes to the lungs and the supraclavicular lymph nodes; however we present a rare case of diethylstilbestrol-induced vaginal CCA with cerebral metastases. A 43-year-old woman with prenatal diethylstilbestrol exposure and history of vaginal CCA treatment 8 years prior to current presentation noted new onset headache and dizziness. MRI showed an enhancing mass in the right frontal lobe. Histopathology was consistent with CCA. This case report highlights the necessity of close extended follow-up in patients with a history of vaginal CCA and demonstrates the potential for spread of primary vaginal CCA to the brain.