Diethylstilbestrol exposure during pregnancy with primary clear cell carcinoma of the cervix in an 8-year-old granddaughter: a multigenerational effect of endocrine disruptors?

Author:

Gaspari Laura,Paris Françoise123,Cassel-Knipping Nathalie4,Villeret Julia5,Verschuur Arnauld6,Soyer-Gobillard Marie-Odile7,Carcopino-Tusoli Xavier8,Hamamah Samir93,Kalfa Nicolas210,Sultan Charles12

Affiliation:

1. Unité d’Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier et Université Montpellier, Montpellier, France

2. Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier, Montpellier, France

3. INSERM U 1203, Montpellier, France

4. Polyclinique Urbain V, Avignon, France

5. Hôpital Henri Duffaut, Service de Pathologie, Avignon, France

6. Hôpital d’Enfants de la Timone, Centre de Cancérologie Pédiatrique, Marseille, France

7. CNRS, Université Sorbonne, Association Hhorages-France, F-Asnières-sur-Oise, France

8. Département de Gynécologie, Hôpital Nord Marseille, Marseille, France

9. Département de Biologie de La Reproduction et DPI (ART/PGD), Hôpital A. de Villeneuve, CHU Montpellier et Université, Montpellier, France

10. Département de Chirurgie Pédiatrique, Hôpital Lapeyronie, CHU Montpellier et Université Montpellier 1, Montpellier, France

Abstract

ABSTRACT To date, vaginal/cervical clear cell adenocarcinoma (CCAC) has not been reported in the granddaughters of women treated with diethylstilbestrol (DES) during pregnancy. We present an 8-year-old girl with a history of severe vaginal bleeding who was diagnosed with cervical CCAC. She underwent fertility-sparing surgery and radiotherapy. No sign of recurrence was detected throughout a 10-year follow-up. Her grandmother had received DES therapy during pregnancy with the patient’s mother. Although no direct causal link is demonstrated, this case raises for the first time, the hypothesis of multigenerational effects of DES in girls and strongly suggests the need to follow the granddaughters of DES-treated women.

Publisher

Oxford University Press (OUP)

Subject

Obstetrics and Gynecology,Rehabilitation,Reproductive Medicine

Reference32 articles.

1. Pediatric radical abdominal trachelectomy for cervical clear cell carcinoma: a novel surgical approach;Abu-Rustum;Gynecol Oncol,2005

2. Clear cell adenocarcinoma of the cervix in a child without in utero exposure to diethylstilbestrol: a case report and review of the literature;Ahrens;Pediatr Dev Pathol,2005

3. Clear cell adenocarcinoma of the cervix in a ten-year-old girl without prenatal diethylstilbestrol exposure;Andi Asri;Singapore Med J,2016

4. Clear cell adenocarcinoma of cervix in 1-year-old girl without in utero exposure to diethylstilbestrol: an uncommon tumour at an uncommon age and site;Arora;BMJ Case Rep,2017

5. Ovarian carcinoma in an adolescent with transgenerational exposure to diethylstilbestrol;Blatt;J Pediatr Hematol Oncol,2003

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