Presentation
Eight cases of microglandular hyperplasia arising in vaginal adenosis are presented. [ncbi.nlm.nih.gov]
Risk is however still present in subsequent generations due to recent exposure.It is thought steroid hormones play a stimulatory growth in adenosis formation. Vaginal adenosis is also often observed in adenocarcinoma patients. [en.wikipedia.org]
Entire Body System
- Localized Pain
pain, vaginal bleeding, abdominal bloating or a mass. [cancerjournal.net]
Urogenital
- Vaginal Discharge
However, it should be considered as a possible diagnosis in girls with persistent vaginal discharge. [ncbi.nlm.nih.gov]
A 40year-old female presented with complaints of persistent excessive watery vaginal discharge. On examination, there was red, patchy, diffuse lesion all over the vaginal wall and cervix. [semanticscholar.org]
Plouffe L, Hansen K, Hanly M: Vaginal adenosis following transverse vaginal septum resection as a cause of profuse vaginal discharge. Fertil Steril 1997;68(suppl 1):180–181. Herbst AL: Diethylstilbestrol and adenocarcinoma of the vagina. [karger.com]
- Profuse Vaginal Discharge
Plouffe L, Hansen K, Hanly M: Vaginal adenosis following transverse vaginal septum resection as a cause of profuse vaginal discharge. Fertil Steril 1997;68(suppl 1):180–181. Herbst AL: Diethylstilbestrol and adenocarcinoma of the vagina. [karger.com]
Workup
[…] histopathologic features with data from ancillary techniques such as immunohistochemistry and cytogenetics and discussions of the relevant clinical manifestations of gynecological diseases to provide you with the necessary tools to make a comprehensive diagnostic workup [books.google.com]
Otherwise, the antibiotic is changed according to the fever workup and cultures are obtained. If the cultures are negative for infection, then the antibiotics should be changed to cover anaerobic and gram-negative organisms. [emedicine.medscape.com]
Proctoscopy
- Rectal Ulcer
Our polyps (case 1 & 2) were histologically identical to those of rectal mucosal prolapse, inflammatory cloacogenic polyp or solitary rectal ulcer syndrome. [diagnosticpathology.biomedcentral.com]
Other Pathologies
- Lymphocytic Infiltrate
Vazmitel M., Michal M., Kazakov D.V.: Merkel cell carcinoma with a follicular lymphocytic infiltrate: report of two cases. American Journal of Dermatopathology, 30, 389-391, 2008. [sikluv-ustav-patologie.patologie.cz]
Treatment
Vaginal adenosis and clear cell adenocarcinoma of the vagina occurred in a 44-year-old woman after treatment for condylomata acuminata. She had no known exposure to diethylstilbestrol (DES) in utero. [ncbi.nlm.nih.gov]
Treatment Additional Treatment General Measures Unless malignancy is present, conservative treatment is indicated. In the vast majority of young females with this condition, it will resolve with expectant management (4)[C]. [tipsdiscover.com]
Prognosis
Until the natural history of sufficient numbers of these variants of vaginal adenosis have been studied, the analogous cervical condition may serve as a guide to prognosis. [ncbi.nlm.nih.gov]
Prognosis is significantly dependent on stage. [radiopaedia.org]
Histlogical grade Overexpression of HER-2/neu rare ==> aggressive More favorable prognosis if overexpression of wild-type p53 protein than in tumors containing mutated p53 genes. [neoadjuvant.wikidot.com]
The prognosis is mostly related to the underlying cause and its treatment Who gets Adenosis of Vagina? (Age and Sex Distribution) Vaginal Adenosis is a common condition that is mostly seen in adult (healthy) women. [dovemed.com]
Etiology
Vaginal adenosis, without a history of diethylstilbestrol (DES) exposure, is a rare condition with an unclear etiology. A 24-year-old female presented with complaints of persistent vaginal discharge and dyspareunia. [ncbi.nlm.nih.gov]
The cervical and vaginal CCACs are generally negative for human papilloma virus (HPV) infection, and their etiology is not understood. [grantome.com]
In DES-exposed females, the incidence of adenosis is higher; the etiology presumably is from the effect of the DES on the developing embryologic system. [tipsdiscover.com]
ETIOLOGY/PATHOGENESIS Spontaneous (Developmental Anomaly) Postembryonic persistence of müllerian-type epithelium Environmental Exposure In utero exposure to diethylstilbestrol (DES) If < 8th week gestation, 100% develop adenosis If > 15th week gestation [basicmedicalkey.com]
Nasrin Akhter and Sakti Das and Afroza Kutubi}, year={2013} } Shamsun Nahar Begum Hena, Nasrin Akhter, +1 author Afroza Kutubi Published 2013 Vaginal adenosis, without a history of diethylstilbestrol (DES) exposure, is a rare condition with an unclear etiology [semanticscholar.org]
Epidemiology
Diagnostic criteria and microbial and epidemiologic associations. Am J Med. Seite 193 - Henson D, Tarone R. An epidemiologic study of cancer of the cervix, vagina, and vulva based on the Third National Cancer Survey in the United States. [books.google.de]
Epidemiology Incidence Although the cumulative incidence of vaginal adenosis is unknown, the incidence of cloacal malformations is 1/20,000 to 1/25,000 live births. [unboundmedicine.com]
Epidemiology Incidence While the incidence of vaginal adenosis is unknown, the incidence of cloacal malformations is 1/20,000 to 1/25,000 live births. Predominant age: Teenage years: Epithelialization occurs from puberty to ∼20 years of age. [tipsdiscover.com]
[…] glands can also be present Women are at risk of neoplasia, including clear cell adenocarcinoma, as well as squamous dysplasia ICD coding N89.8 Other specified noninflammatory disorders of vagina N89.9 Noninflammatory disorder of vagina, unspecified Epidemiology [pathologyoutlines.com]
In 1971 a retrospective epidemiologic study showed a close association of this therapy with occurrence of vaginal and cervical adenocarcinoma in young women (mean age 19 years). [desdaughter.com]
Pathophysiology
Anomalies of the uterus Anomalies of Müllerian duct fusion Anomalies of Müllerian duct fusion Types of fusion anomalies Relative frequency Pathophysiology Müllerian agenesis (Class I ) Rare Both the Müllerian ducts fail to develop → absent or hypoplastic [amboss.com]
Predominant age Age Prepubertal: typically absent Age 13 to 25 years: 13% Age >25 years: decreasing prevalence, uncommon beyond age 30 years ( 2 ) Etiology and Pathophysiology In most young females, the etiology is incomplete squamous metaplasia or epithelialization [unboundmedicine.com]
General Prevention None: Last DES exposure in the 1970s Pathophysiology In the vast majority of young females, the etiology is incomplete squamous metaplasia or epithelialization. This occurs as a natural phenomenon and resolves with age. [tipsdiscover.com]
[…] in 2 - 10% of nonexposed females Sites Involves the upper third of the vagina (34% of DES exposed cases), with the anterior wall more frequently involved than the posterior wall Middle third (9% of cases) and lower third (2% of cases) may be involved Pathophysiology [pathologyoutlines.com]
Prevention
DES was last used to prevent spontaneous abortion in the US in 1971; therefore, it is decreasing in clinical significance. [tipsdiscover.com]
This presentation is a narrative about diethylstilbestrol (DES) which was first synthesized in 1938 and prescribed from the 1940s to 1971 to try to prevent complications of pregnancy. [iupui.edu]
DES is a synthetic, nonsteroidal estrogen used to prevent miscarriage or premature deliveries from 1938 to 1971 ( 3 ). An estimated 5 million women were prescribed DES during this period ( 4 ). [unboundmedicine.com]
DES, an orally active synthetic estrogen, was believed to prevent adverse pregnancy outcome and thus was routinely given to selected pregnant women from the 1940s to the 1960s. [ncbi.nlm.nih.gov]
Oestrogen supplementation, mainly diethylstilbestrol, for preventing miscarriages and other adverse pregnancy outcomes. Cochrane Database Syst Rev. 200... [5minuteconsult.com]