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doctorF 04-15-2010 03:02 PM

T-shaped uternine cavity
A 28 year old woman with history of infertility and spontaneous abortions has a hysterosalpingogram that demonstrates a T-shaped uterine cavity. A transverse ridge in the upper vagina and cervical stenosis are also noted during the procedure. Biopsy of the upper third of the woman's vagina would most likely show :

(A) clear cell adenocarcinoma
(B) embryonal rhabdomyosarcoma
(C) squamous carcinoma
(D) squamous metaplasia
(E) vaginal adenosis

ath.pantelis 04-15-2010 03:47 PM

This poor woman's mother must have been exposed to DES (diethylstilbestrol), which is mainly notorious for causing T-shaped uterus & clear cell adenocarcinomas to DES daughters (among other sequellae, such as breast cancer & ectopic pregnancies). NEJM (what a surprise!) was the first journal to publish such evidence in the early 70's.

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