Clear cell adenocarcinoma of the cervix unrelated to diethylstilbestrol exposure.

Twenty-three cases of clear cell adenocarcinoma unrelated to diethylstilbestrol (DES) exposure are described. The microscopic appearance of clear cell and hobnail-shaped cells arranged in a solid, tubular, microcystic, or papillary pattern is diagnostic. Four of the tumors were associated with mesonephric remnants, but none could be demonstrated to arise in them. The age range of the patients, 13 to 80 years, serves as a reminder that DES is not an etiologic factor in many cases and that the disease can occur in older women. Nulliparous patients were unexpectedly common (67% of the total), and the survival rate at ten years was 57%.