Childhood Cervical And Vaginal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]

Risk Factors and Clinical Presentation

Adenocarcinoma of the cervix and vagina is rare in childhood and adolescence.[1,2] Two-thirds of cases in previous reports have been associated with exposure to diethylstilbestrol (DES) in utero.[3] However, the few case reports of vaginal cancer in children in the last decade have not been associated with exposure to DES in utero.[4]

The median age at presentation is 15 years, with a range of 7 months to 18 years. Most patients present with vaginal bleeding. Adults with adenocarcinoma of the cervix or vagina present with stage I or stage II disease 90% of the time.[1] In children and adolescents, there is a high incidence of stage III and stage IV disease (24%). This difference may be explained by the practice of routine pelvic examinations in adults and the hesitancy to perform them in children.

References:

1. McNall RY, Nowicki PD, Miller B, et al.: Adenocarcinoma of the cervix and vagina in pediatric patients. Pediatr Blood Cancer 43 (3): 289-94, 2004.
2. You W, Dainty LA, Rose GS, et al.: Gynecologic malignancies in women aged less than 25 years. Obstet Gynecol 105 (6): 1405-9, 2005.
3. Huo D, Anderson D, Palmer JR, et al.: Incidence rates and risks of diethylstilbestrol-related clear-cell adenocarcinoma of the vagina and cervix: Update after 40-year follow-up. Gynecol Oncol 146 (3): 566-571, 2017.
4. Fernandez-Pineda I, Spunt SL, Parida L, et al.: Vaginal tumors in childhood: the experience of St. Jude Children's Research Hospital. J Pediatr Surg 46 (11): 2071-5, 2011.