Primary vaginal mucinous adenocarcinoma of intestinal type, associated with intestinal metaplasia of Skene ducts in a diethylstilbestrol-exposed woman.
OBJECTIVE
Primary mucinous vaginal adenocarcinoma of intestinal type is an extremely rare malignancy of uncertain histogenesis, which makes for a diagnostic challenge. We report a case and describe the histopathologic features and the unusual immunoprofile of this rare entity.


METHODS
We report a case of vaginal mucinous adenocarcinoma of intestinal type in a diethylstilbestrol-exposed woman in which intestinal metaplasia of the Skene duct was found at the time of recurrence.


RESULTS
As the histogenesis of primary vaginal intestinaltype adenocarcinomas remains uncertain, the finding of Skene duct metaplasia in association with invasive adenocarcinoma lends support to the origin of vaginal mucinous adenocarcinomas of intestinal type to be metaplasia, at least in some cases. Such an origin accounts for the unusual immunohistochemical profile, which raises concern for a metastatic adenocarcinoma of gastrointestinal origin.


CONCLUSIONS
Recognition of this rare entity is important, particularly to avoid the pitfall of misdiagnosing metastatic disease.
From the Departments of Pathology and Laboratory Medicine and Kanayo.Tatsumi@vtmednet.org.
Kanayo
K
Tatsumi
Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Burlington.
Brooke
B
Schlappe
Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Burlington.
Elise N
EN
Everett
From the Departments of Pathology and Laboratory Medicine and.
Pamela C
PC
Gibson
From the Departments of Pathology and Laboratory Medicine and.
Sharon L
SL
Mount
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology*; D004054:Diethylstilbestrol; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000473:pathology*; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000378:metabolism / Q000473:pathology; D014625:Vaginal Neoplasms / Q000378:metabolism / Q000473:pathology*
D004054:Diethylstilbestrol
Intestinal metaplasia; Skene gland adenocarcinoma; Vaginal adenocarcinoma