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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
This nonsteroidal synthetic estrogen, approved by the Food and Drug Administration in 1942 for use in pregnancy to prevent miscarriages, is strongly associated with an increased frequency of clear-cell adenocarcinoma of the vagina and cervix among daughters of women treated with diethylstilbestrol (DES) early in pregnancy. Between 500,000 and two million pregnant women took this drug. In a registry including more than 400 cases of clear-cell adenocarcinoma of the vagina and cervix diagnosed in the US since 1971, no less than 65 percent of patients’ mothers took DES in early pregnancy (Herbst, 1981). Of the women who took DES early in pregnancy, 80 percent had taken it during the 12 weeks prior to conception. The malignancy was diagnosed among females 7–30 years old, with a median age of 19 years. Estimates suggest that 0.14–1.4 per 1,000 daughters of women treated with DES during pregnancy will develop clear-cell adenocarcinoma of the vagina or cervix by the age of 24.
Carcinoma of the Vagina and Vulva
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Sadaf Ghaem-Maghami, Kostas Lathouras
For some time, the prevalence of clear cell adenocarcinoma of the vagina was thought to be increased by intrauterine exposure to diethylstilbestrol (DES), but with the accrual of more information, the risks now seem to be very low and lie between 0.1 and 1.0 per 1000.6–8
Habitual Abortion
Published in E. Nigel Harris, Thomas Exner, Graham R. V. Hughes, Ronald A. Asherson, Phospholipid-Binding Antibodies, 2020
Dwight D. Pridham, Christine L. Cook
During the 1950s nearly 2 million individuals are estimated to have been exposed to a teratogen, diethylstilbestrol (DES), which has been shown definitively to affect the reproductive tract. Among affected women, adenosis and clear cell adenocarcinoma occur at a higher rate than expected. Structural abnormalities of the vagina and cervix are common in this population. In addition, hysterosalpingography has demonstrated a change in the upper mullerian tract in many exposed women. The importance of these latter two findings in infertility and pregnancy wastage is debated.
Cutaneous metastases in renal cell carcinoma: a systematic review and a case report
Published in Scandinavian Journal of Urology, 2019
Rikard Ohlsson, Louise Geertsen, Stine Berge Stuveseth, Lars Lund
During the hospitalization, a multiphase C.T.-scan was performed where a 5 × 5 cm solid tumor was found in the left kidney. The patient was referred to a standardized work-up regimen for suspected cancer (‘kraeftpakkeforl⊘b’) where a biopsy of the tumor, a renography and a chest C.T. was performed. The histology showed clear cell adenocarcinoma. There was no evidence of disseminated disease and a left-sided laparoscopic nephrectomy was performed without complications. The histology showed clear cell adenocarcinoma, Fuhrman grade 3, pT1b N0, Leibovich score 4 with free resection margins. A surveillance schedule was planned with C.T. of chest and abdomen every 12 months for 4 years, followed by every other year with a total follow-up of 8 years.
Postmenopausal endometriosis: drawing a clearer clinical picture
Published in Climacteric, 2018
Both ovarian and extraovarian endometriosis have the potential for malignant change. A 2001 review of 1000 consecutive cases of surgically proven endometriosis demonstrated that cancers were more commonly found in ovaries when endometriosis was present in that ovary (5%) compared to when endometriosis was present at other sites (1%)20. Clear cell and endometrioid carcinomas were the malignancies most commonly seen in ovaries containing endometriosis, while clear cell adenocarcinoma and adenosarcoma were most commonly seen in conjunction with extraovarian endometriosis.
Does the environment affect menopause? A review of the effects of endocrine disrupting chemicals on menopause
Published in Climacteric, 2023
The prototypical EDC is diethylstilbestrol (DES), a synthetic non-steroidal estrogen that was prescribed to pregnant women to prevent recurrent pregnancy loss from the 1940s until 1975 [7]. DES was ultimately found to be both ineffective in preventing miscarriage and associated with adverse reproductive outcomes in multiple generations of offspring of the exposed mother, including vaginal clear cell adenocarcinoma, reproductive tract malformations, subfertility, miscarriage and early menopause [10].