Late recurrence of clear-cell adenocarcinoma of the cervix: case report

In the last 10 years, new observations have been made of the biologic behavior of clear-cell adenocarcinoma of the cervix and vagina arising in young women exposed to diethylstilbestrol in utero. Of particular note is the tumor's capacity to recur after an extended disease-free interval following initial therapy. We report the case of a woman who had her first recurrence 17 years after initial therapy, presenting with metastatic disease to the lungs and cerebellum. This case represents the longest reported interval between primary therapy and recurrence and supports the conclusion made by others that women who have been treated for clear-cell adenocarcinoma of the cervix and vagina may remain at risk of disease progression for many years after initial therapy. Therefore, these women should continue to be monitored. We also recommend periodic chest x-rays for two reasons: 1) The lungs are the most common site of distant spread of disease; and 2) metastatic nodules may be amenable to curative surgical intervention.