Cervical-Vaginal Adenosis after in utero exposure to synthetic estrogens.

A study to determine the incidence of adenosis and/or adenocarcinoma of the vagina in 528 females between 13 and 25 years who were exposed to diethlstilbesterol in utero and to define the clinical and microscopic changes in their vaginas was undertaken using primary physicians records as a source for patient identification. Lugols staining was evaluated and was found to be a simple technique for identifying the lesion of adenosis. Of the young women with documented exposure to diethylstilbesterol or dienestrol over 90% had adenosis of the vagina. In almost all cases the drug treatment began before the twelfth gestational week. In some patients the appearance of the cervix was unusual. Of the 188 patients who underwent excisional biopsy 2 showed a small focus of clear cell adenocarcinoma which was not detected clinically. A causal relationship between in utero exposure to diethylstilbesterol or dienestrol is suggested. It is also suggested that the lesion is developmental since it has been found in prepubertal girls.