Primary clear cell adenocarcinoma of cervix in a young women: A rare entity

Abstract

Cervical cancer is the most common gynaecological malignancy worldwide. The most common type of cervical carcinoma is squamous cell carcinoma followed by adenocarcinoma of cervix, which constitutes only 15% of cases. Adenocarcinoma of cervix can be categorized histologically into clear cell, mucinous, endometrioid, serous and mesonephric subtypes. Clear cell adenocarcinoma (CCA) most commonly occurs in the ovary, followed by endometrium, vagina, and cervix. Primary CCA of cervix is a rare neoplastic entity, which occurs in young women exposed to diethylstilbestrol (DES) in utero. It is extremely rare in women without in utero DES exposure and in such cases it concerns mostly postmenopausal women. Here, we present a case of 30 year old woman who presented with primary infertility. There was no history of in-utero exposure to diethyl stilbestrol. She was diagnosed a case of cervical fibroid on ultrasonography. Diagnostic hysteroscopy was done and she was found to have friable, vascular growth in endocervix, which was extending to uterine cavity. Biopsy was taken. On histopathology, moderately differentiated clear cell adenocarcinoma of cervix was reported. Through this case, authors would like to highlight the probability of rare occurrence and how to manage challenges posed by cervical cancer in young girl wishing to conceive, stressing on the role of hysteroscopy in diagnosis.