Question

Young women whose mothers took diethylstilbestrol during pregnancy are likely to develop one of the following genital malignancy

• A. Squamous-cell carcinoma
• B. Adenosquamous carcinoma
• C. Papillary adenocarcinoma
• D. Clear-cell adenocarcinoma

Hint:

Recall which rare vaginal cancer was first traced back to a drug given to pregnant mothers.

Answer 1

The Correct Option is D

Diethylstilbestrol, or DES, is a synthetic hormone that doctors once gave to pregnant women hoping to prevent miscarriage. Its use came with a hidden cost for the daughters born from those pregnancies, and the question asks what cancer that cost turned out to be.

1. Squamous cell carcinoma: this is the usual type of cervical cancer in the general population and is linked to persistent high risk HPV infection, not to a mother's DES use.
2. Adenosquamous carcinoma: a mixed tumor pattern that is not the one historically tied to DES daughters.
3. Papillary adenocarcinoma: not the cancer type reported in this exposed group either.
4. Clear cell adenocarcinoma: DES exposure before birth leaves behind patches of glandular tissue in the vagina called adenosis, and it was cancer arising from these patches, specifically clear cell adenocarcinoma, that alerted doctors in the 1970s to the danger of DES.

Since clear cell adenocarcinoma of the vagina and cervix is the cancer that was actually traced back to prenatal DES exposure, it stands apart from the other three options.

Let's summarize:

• DES exposure in the womb causes vaginal adenosis in daughters.
• Cancer arising from that adenosis, clear cell adenocarcinoma, is the malignancy tied to DES.

So the answer is clear cell adenocarcinoma.