Murat ULUKUŞ, Nedim KARADADAŞ, Fuat AKERCAN, Mustafa ULUKUŞ, Coşan TEREK, Osman ZEKİOĞLU

Diethylstilbestrol kullanım öyküsü olmayan 40 yaşındaki olguda spontan vaginal adenozis: Olgu sunumu

Vaginal adenozis, metaplastik servikal ya da endometriyal bezlerin vagina duvarları içerisinde bulunması olarak tanımlanmaktadır. Bu tanımlama vaginadaki tüm Mülleryan tipteki glandüler epiteli kapsamaktadır. Prenatal olarak diethylstilbestrole (DES) maruz kalan kadınların %90'ından fazlasında görülebilmekle beraber, spontan olarak da oluşabilmektedir. Bu çalışmada 40 yaşında spontan olarak gelişmiş bir vaginal adenozis vakası sunulmuştur.

Anahtar Kelimeler:

Erişkin, Vajina, Vajina hastalıkları, Dietilstilbestrol, Epitel tabakası, Metaplazi

Asymptomatic vaginal adenosis in a non-diethylstilbestrol-exposed 40-year-old patient: A case report

Adenosis of the vagina is defined as the presence of the metaplastic cervical or endometrial epithelium within the vaginal wall. This definition has been expanded to embrace the presence of any Mullerian type glandular epithelium in the vagina. As it may arise in up to 90% of women prenatally exposed to diethylstilbestrol (DES), it may also arise spontaneously. We report a 40-year-old case of spontaneously induced vaginal adenosis.

Keywords:

Adult, Vagina, Vaginal Diseases, Diethylstilbestrol, Epithelium, Metaplasia,

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1. Chattopadhyay I, Cruickshan DJ, Packer M. Non diethylstilbesterol induced vaginal adenosis, a case series and review of the literatüre. Eur J Gynaecol Oncol 2001; 22: 260-262
2. Robboy SJ, Hill EC, Sandberg EC, Czernobilsky B. Vaginal adenosis women born prior to diethylstilbesterol era. Hum Pathol 1986; 17:488-492
3. Ghosh TK, Cera PJ. Transition of benign vaginal adenosis. to clear cell adenocarcinoma. Obstet Gynecol 1983; 61:126-130
4. Chariton A, Kirker JA, Robertson AK, Jones RW. Vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors. Aust N Z J Obstet Gynaecol 2001 Feb;41: 97-99
5. Maassen V, Lampe B, Untch M, et al. Geburtshilfe Frauenheilkd 1993 ;53: 308-313
6. Herbst AL, Kurman RJ, Skully RE. Vaginal and cervical abnormalities after exposure to stilbesterol in utero. Obstet Gynecol 1972; 40: 287-298.
7. Antonioli DA, Burke L. Vaginal adenosis: analysis of 325 biopsy specimens from 100 patients. Am J Clin Pathol 1975; 64: 625-638.
8. Kaufman RH, Korhonen MO, Strama T, Adam E, Kaplan A. Development of clear cell adenocarcinoma in DES-exposed offspring under observation. Obstet Gynecol 1982; 59(suppl): 68S-72S.
9. Kurman RJ, Scully RE. The incidence and histogenesis of vaginal adenosis. Hum Pathol 1974; 5:265-276.
10. Doshi N, Fujikara T, Kanbour A. Vaginal adenosis and polycystic ovaries during infancy and childhood. Am J Obstet Gynecol 1977; 129:374-378.
11. Kranl C, ZelgerB, KoflerH, etal.Vulval and vaginal adenosis. Br Jdermatol 1998; 139: 128-131.
12. Marquette GP, Su B, Woodruff JD. Introital adenosis associated with Stevens-Johnson syndrome. Obstet Gynecol 1985; 66: 143- 145.
13. Hansen K, Egholm M. Diffuse vaginal adenosis: Three cases with imperforate hymen and haematocolpos. Açta Obstet Gynecol scand 1975; 54: 287-292.
14. Goodman A, Zukerberg LR, Nikrui N, Scully RE. Vaginal adenosis and clear cell carcinoma after 5-fluorouracil treatment for condylomas. Cancer 1991; 68: 1628-1632.
15. Dunger CF, Wilkinson EJ. Vaginal columnar cell metaplasia. An acquired adenosis associated with topical 5-fluorouracil therapy. J Reprod Med 1995 ; 40: 361-366.
16. Merchant WJ, Gale J. İntestinal metaplasia in stilbesterol induced vaginal adenosis. Histopathology 1993; 23: 373-376.
17. Robboy SJ, Welch WR, Young RH, et al. Topographic relation of cervical ectropion and vaginal adenosis to clear cell adenocarcinoma. Obstet Gynecol 1982; 60: 546-551.
18. Antonioli DA, Burke L, Friedman EA. Natural history of diethylstilbestrol-associated genital lesions: Cervical ectopy and cervicovaginal lood. Am J Obstet Gynecol 1980; 137:847
19. Robboy SJ, Szyfelbein WM, Goellner JR, et al. Displasia and cytologic findings in 4589 young vromen enrolled in diethylstilbestroladenosis (DESAD) project. Am J Obstet Gynecol 1981; 140:579
20. Melnick S, Cole P, Anderson D, Herbst A. Rates and risks of diethylstilbestrol related clear cell adenocarcinoma of the vagina and the cervix. N Engl J Med 1987; 316: 514-516.