It is 1985. An 18 year old woman presents to your office with a diagnosis of adenocarcinoma of the vagina. There is no family history of any cancers.
Challenge: Tell me about her mother.
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I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
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1 comment:
History Lesson
The patient was exposed to the chemical diethylstilbestrol (DES) in utero. So-called DES daughters (if the mother received DES during pregnancy) have a 40-fold increase in risk of clear cell adenocarcinoma of the vagina and cervix, usually diagnosed in the late teens and twenties (most cases in non-exposed women occur postmenopausally). These patients are also at higher risk for congenital anomalies and epithelial changes of the reproductive tract, fertility problems, earlier menopause, and breast cancer. DES is a nonsteroidal estrogen initially used for postmenopausal symptoms and prevention of pregnancy related problems (such as miscarriage). Its use was stopped in 1971 after its adverse health effects were discovered. It is the only firmly established transplacental carcinogen in humans.
Source: UpToDate.
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