Clear cell carcinoma of the female genital tract (not everything is as clear as it seems)

Advances in Anatomic Pathology

Volumn 19, Issue 5, 2012, Pages 296-312

  Offman, Saul L ^a   Longacre, Teri A ^a  

^a STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

cervix; clear cell carcinoma; endometriosis; ovary; uterus

Indexed keywords

ANTINEOPLASTIC AGENT; CYTOKERATIN 20; CYTOKERATIN 7; ESTROGEN RECEPTOR; GLYPICAN 3; HEPATOCYTE NUCLEAR FACTOR; PLATINUM DERIVATIVE; TAMOXIFEN; TRANSCRIPTION FACTOR PAX8; WT1 PROTEIN;

ABDOMINAL HYSTERECTOMY; CANCER CHEMOTHERAPY; CANCER LOCALIZATION; CANCER PROGNOSIS; CANCER RADIOTHERAPY; CANCER SURGERY; CERVICOVAGINAL CLEAR CELL CARCINOMA; CLEAR CELL CARCINOMA; CLINICAL FEATURE; CYSTADENOMA; DIAGNOSTIC PROCEDURE; DIAGNOSTIC TEST; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DISEASE SEVERITY; DISEASE SPECIFIC SURVIVAL; DYSGERMINOMA; ENDOMETRIOID CARCINOMA; ENDOMETRIOSIS; ENDOMETRIUM CARCINOMA; FEMALE; FEMALE GENITAL TRACT CANCER; FEMALE GENITAL TRACT CLEAR CELL CARCINOMA; GENE EXPRESSION; GENETIC ANALYSIS; GRANULOSA CELL TUMOR; GYNECOLOGIC SURGERY; HEREDITARY NONPOLYPOSIS COLORECTAL CANCER; HISTOPATHOLOGY; HUMAN; IMMUNOHISTOCHEMISTRY; JUVENILE GRANULOSA CELL TUMOR; KARYOTYPING; KIDNEY METASTASIS; LYMPHADENECTOMY; MICROSCOPY; MOLECULAR PATHOLOGY; MUCINOUS CARCINOMA; OVARIAN CLEAR CELL CARCINOMA; OVARIAN MUCINOUS CARCINOMA; OVARY CARCINOMA; OVARY METASTASIS; OVARY TUMOR; OVERALL SURVIVAL; PAPILLARY CLEAR CELL CYSTADENOMA; PATHOPHYSIOLOGY; PERITONEAL CLEAR CELL CARCINOMA; PERITONEUM CANCER; PREVALENCE; PRIORITY JOURNAL; PROGRESSION FREE SURVIVAL; REVIEW; RISK FACTOR; SALPINGOOOPHORECTOMY; STEROID CELL TUMOR; TREATMENT RESPONSE; UTERINE CERVIX CARCINOMA; UTERINE CLEAR CELL CARCINOMA; UTERUS CARCINOMA; VAGINECTOMY; YOLK SAC TUMOR;

ADENOCARCINOMA, CLEAR CELL; CARCINOMA, ENDOMETRIOID; CARCINOMA, RENAL CELL; CYSTADENOCARCINOMA, SEROUS; DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC ERRORS; DNA, NEOPLASM; DYSGERMINOMA; ENDODERMAL SINUS TUMOR; FEMALE; GENITAL NEOPLASMS, FEMALE; GRANULOSA CELL TUMOR; HUMANS; MOLECULAR DIAGNOSTIC TECHNIQUES; MUTATION; PATHOLOGY, MOLECULAR; SEX CORD-GONADAL STROMAL TUMORS;

EID: 84865477390     PISSN: 10724109     EISSN: 15334031     Source Type: Journal    
DOI: 10.1097/PAP.0b013e31826663b1     Document Type: Review

References (110)

1. Chan JK, Teoh D, Hu JM, et al. Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers. Gynecol Oncol. 2008;109:370-376.
2. Kobel M, Kalloger SE, Huntsman DG, et al. Differences in tumor type in low-stage versus high-stage ovarian carcinomas. Int J Gynecol Pathol. 2010;29:203-211.
3. Seidman JD, Horkayne-Szakaly I, Haiba M, et al. The histologic type and stage distribution of ovarian carcinomas of surface epithelial origin. Int J Gynecol Pathol. 2004;23:41-44. (Pubitemid 38018236)
4. Sugiyama T, Kamura T, Kigawa J, et al. Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer. 2000;88:2584-2589. (Pubitemid 30331967)
5. Itamochi H, Kigawa J, Terakawa N. Mechanisms of chemoresistance and poor prognosis in ovarian clear cell carcinoma. Cancer Sci. 2008;99:653-658. (Pubitemid 351448066)
6. Goff BA, Sainz de la Cuesta R, Muntz HG, et al. Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol Oncol. 1996;60:412-417. (Pubitemid 26077628)
7. Matsuura Y, Robertson G, Marsden DE, et al. Thromboembolic complications in patients with clear cell carcinoma of the ovary. Gynecol Oncol. 2007;104:406-410. (Pubitemid 46135653)
8. Duska LR, Garrett L, Henretta M, et al. When "neverevents" occur despite adherence to clinical guidelines: the case of venous thromboembolism in clear cell cancer of the ovary compared with other epithelial histologic subtypes. Gynecol Oncol. 2010;116:374-377.
9. Savvari P, Peitsidis P, Alevizaki M, et al. Paraneoplastic humorally mediated hypercalcemia induced by parathyroid hormone-related protein in gynecologic malignancies: a systematic review. Onkologie. 2009;32:517-523.
10. Jensen KC, Mariappan MR, Putcha GV, et al. Microsatellite instability and mismatch repair protein defects in ovarian epithelial neoplasms in patients 50 years of age and younger. Am J Surg Pathol. 2008;32:1029-1037.
11. Garg K, Leitao MM Jr., Kauff ND, et al. Selection of endometrial carcinomas for DNA mismatch repair protein immunohistochemistry using patient age and tumor morphology enhances detection of mismatch repair abnormalities. Am J Surg Pathol. 2009;33:925-933.
12. Fukunaga M, Nomura K, Ishikawa E, et al. Ovarian atypical endometriosis: its close association with malignant epithelial tumours. Histopathology. 1997;30:249-255. (Pubitemid 27148154)
13. Ogawa S, Kaku T, Amada S, et al. Ovarian endometriosis associated with ovarian carcinoma: a clinicopathological and immunohistochemical study. Gynecol Oncol. 2000;77:298-304. (Pubitemid 30317153)
14. Munksgaard PS, Blaakaer J. The association between endometriosis and ovarian cancer: a review of histological, genetic and molecular alterations. Gynecol Oncol. 2012;124:164-169.
15. Higashi M, Kajiyama H, Shibata K, et al. Survival impact of capsule rupture in stage I clear cell carcinoma of the ovary in comparison with other histological types. Gynecol Oncol. 2011;123:474-478.
16. Veras E, Mao TL, Ayhan A, et al. Cystic and adenofibromatous clear cell carcinomas of the ovary: distinctive tumors that differ in their pathogenesis and behavior: a clinicopathologic analysis of 122 cases. Am J Surg Pathol. 2009;33:844-853.
17. Cuff J, Longacre TA. Endometriosis does not confer improved prognosis in ovarian carcinoma of uniform cell type. Am J Surg Pathol. 2012;36:688-695.
18. Erzen M, Rakar S, Klancnik B, et al. Endometriosis-associated ovarian carcinoma (EAOC): an entity distinct from other ovarian carcinomas as suggested by a nested casecontrol study. Gynecol Oncol. 2001;83:100-108. (Pubitemid 32959885)
19. Komiyama S, Aoki D, Tominaga E, et al. Prognosis of Japanese patients with ovarian clear cell carcinoma associated with pelvic endometriosis: clinicopathologic evaluation. Gynecol Oncol. 1999;72:342-346. (Pubitemid 29118191)
20. Orezzoli JP, Russell AH, Oliva E, et al. Prognostic implication of endometriosis in clear cell carcinoma of the ovary. Gynecol Oncol. 2008;110:336-344.
21. Pectasides D, Fountzilas G, Aravantinos G, et al. Advanced stage clear-cell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience. Gynecol Oncol. 2006;102:285-291. (Pubitemid 44041640)
22. Crotzer DR, Sun CC, Coleman RL, et al. Lack of effective systemic therapy for recurrent clear cell carcinoma of the ovary. Gynecol Oncol. 2007;105:404-408. (Pubitemid 46590333)
23. Takano M, Kikuchi Y, Yaegashi N, et al. Clear cell carcinoma of the ovary: a retrospective multicentre experience of 254 patients with complete surgical staging. Br J Cancer. 2006;94:1369-1374. (Pubitemid 43772268)
24. Anglesio MS, Carey MS, Kobel M, et al. Clear cell carcinoma of the ovary: a report from the first Ovarian Clear Cell Symposium, June 24th, 2010. Gynecol Oncol. 2011;121:407-415.
25. Stewart CJ, Brennan BA, Hammond IG, et al. Intraoperative assessment of clear cell carcinoma of the ovary. Int J Gynecol Pathol. 2008;27:475-482.
26. Han G, Gilks CB, Leung S, et al. Mixed ovarian epithelial carcinomas with clear cell and serous components are variants of high-grade serous carcinoma: an interobserver correlative and immunohistochemical study of 32 cases. Am J Surg Pathol. 2008;32:955-964.
27. Bell DA, Scully RE. Benign and borderline clear cell adenofibromas of the ovary. Cancer. 1985;56:2922-2931. (Pubitemid 16216307)
28. Vang R, Whitaker BP, Farhood AI, et al. Immunohistochemical analysis of clear cell carcinoma of the gynecologic tract. Int J Gynecol Pathol. 2001;20:252-259. (Pubitemid 32578111)
29. McCluggage WG, Young RH. Immunohistochemistry as a diagnostic aid in the evaluation of ovarian tumors. Semin Diagn Pathol. 2005;22:3-32. (Pubitemid 43163177)
30. Cameron RI, Ashe P, O'Rourke DM, et al. A panel of immunohistochemical stains assists in the distinction between ovarian and renal clear cell carcinoma. Int J Gynecol Pathol. 2003;22:272-276. (Pubitemid 36750410)
31. Esheba GE, Pate LL, Longacre TA. Oncofetal protein glypican-3 distinguishes yolk sac tumor from clear cell carcinoma of the ovary. Am J Surg Pathol. 2008;32:600-607. (Pubitemid 351458302)
32. Cao D, Guo S, Allan RW, et al. SALL4 is a novel sensitive and specific marker of ovarian primitive germ cell tumors and is particularly useful in distinguishing yolk sac tumor from clear cell carcinoma. Am J Surg Pathol. 2009;33:894-904.
33. Ramalingam P, Malpica A, Silva EG, et al. The use of cytokeratin 7 and EMA in differentiating ovarian yolk sac tumors from endometrioid and clear cell carcinomas. Am J Surg Pathol. 2004;28:1499-1505. (Pubitemid 39425517)
34. Kobel M, Kalloger SE, Carrick J, et al. A limited panel of immunomarkers can reliably distinguish between clear cell and high-grade serous carcinoma of the ovary. Am J Surg Pathol. 2009;33:14-21.
35. Howell NR, Zheng W, Cheng L, et al. Carcinomas of ovary and lung with clear cell features: can immunohistochemistry help in differential diagnosis? Int J Gynecol Pathol. 2007;26:134-140. (Pubitemid 46573208)
36. Kato N, Sasou S, Motoyama T. Expression of hepatocyte nuclear factor-1beta (HNF-1beta) in clear cell tumors and endometriosis of the ovary. Mod Pathol. 2006;19:83-89. (Pubitemid 43250982)
37. Yamamoto S, Tsuda H, Aida S, et al. Immunohistochemical detection of hepatocyte nuclear factor 1beta in ovarian and endometrial clear-cell adenocarcinomas and nonneoplastic endometrium. Hum Pathol. 2007;38:1074-1080. (Pubitemid 46899152)
38. Tsuchiya A, Sakamoto M, Yasuda J, et al. Expression profiling in ovarian clear cell carcinoma: identification of hepatocyte nuclear factor-1 beta as a molecular marker and a possible molecular target for therapy of ovarian clear cell carcinoma. Am J Pathol. 2003;163:2503-2512. (Pubitemid 37466491)
39. Acs G, Pasha T, Zhang PJ. WT1 is differentially expressed in serous, endometrioid, clear cell, and mucinous carcinomas of the peritoneum, fallopian tube, ovary, and endometrium. Int J Gynecol Pathol. 2004;23:110-118. (Pubitemid 38391769)
40. Kobel M, Kalloger SE, Boyd N, et al. Ovarian carcinoma subtypes are different diseases: implications for biomarker studies. PLoS Med. 2008;5:e232.
41. Nonaka D, Chiriboga L, Soslow RA. Expression of pax8 as a useful marker in distinguishing ovarian carcinomas from mammary carcinomas. Am J Surg Pathol. 2008;32:1566-1571.
42. Ozcan A, Liles N, Coffey D, et al. PAX2 and PAX8 expression in primary and metastatic mullerian epithelial tumors: a comprehensive comparison. Am J Surg Pathol. 2011;35:1837-1847.
43. Laury AR, Perets R, Piao H, et al. A comprehensive analysis of PAX8 expression in human epithelial tumors. Am J Surg Pathol. 2011;35:816-826.
44. Zhao L, Guo M, Sneige N, et al. Value of PAX8 and WT1 immunostaining in confirming the ovarian origin of metastatic carcinoma in serous effusion specimens. Am J Clin Pathol. 2012;137:304-309.
45. Kobayashi H, Yamada Y, Kanayama S, et al. The role of hepatocyte nuclear factor-1beta in the pathogenesis of clear cell carcinoma of the ovary. Int J Gynecol Cancer. 2009;19:471-479.
46. Cheng L, Thomas A, Roth LM, et al. OCT4: a novel biomarker for dysgerminoma of the ovary. Am J Surg Pathol. 2004;28:1341-1346. (Pubitemid 39336373)
47. Ahmed AA, Etemadmoghadam D, Temple J, et al. Driver mutations in TP53 are ubiquitous in high grade serous carcinoma of the ovary. J Pathol. 2010;221:49-56.
48. Press JZ, De Luca A, Boyd N, et al. Ovarian carcinomas with genetic and epigenetic BRCA1 loss have distinct molecular abnormalities. BMC Cancer. 2008;8:17.
49. Ho ES, Lai CR, Hsieh YT, et al. p53 mutation is infrequent in clear cell carcinoma of the ovary. Gynecol Oncol. 2001;80:189-193.
50. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15:10-17. (Pubitemid 13194678)
51. Wiegand KC, Shah SP, Al-Agha OM, et al. ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med. 2010;363:1532-1543.
52. Yamamoto S, Tsuda H, Takano M, et al. Loss of ARID1A protein expression occurs as an early event in ovarian clearcell carcinoma development and frequently coexists with PIK3CA mutations. Mod Pathol. 2012;25:615-624.
53. Kuo KT, Mao TL, Jones S, et al. Frequent activating mutations of PIK3CA in ovarian clear cell carcinoma. Am J Pathol. 2009;174:1597-1601.
54. Yamamoto S, Tsuda H, Takano M, et al. PIK3CA mutation is an early event in the development of endometriosis-associated ovarian clear cell adenocarcinoma. JPathol. 2011;225:189-194.
55. Hashiguchi Y, Tsuda H, Inoue T, et al. PTEN expression in clear cell adenocarcinoma of the ovary. Gynecol Oncol. 2006;101:71-75.
56. Wiegand KC, Lee AF, Al-Agha OM, et al. Loss of BAF250a (ARID1A) is frequent in high-grade endometrial carcinomas. J Pathol. 2011;224:328-333.
57. Gilks CB, Ionescu DN, Kalloger SE, et al. Tumor cell type can be reproducibly diagnosed and is of independent prognostic significance in patients with maximally debulked ovarian carcinoma. Hum Pathol. 2008;39:1239-1251.
58. Sangoi AR, Soslow RA, Teng NN, et al. Ovarian clear cell carcinoma with papillary features: a potential mimic of serous tumor of low malignant potential. Am J Surg Pathol. 2008;32:269-274. (Pubitemid 351172142)
59. Ohishi Y, Oda Y, Kurihara S, et al. Hobnail-like cells in serous borderline tumor do not represent concomitant incipient clear cell neoplasms. Hum Pathol. 2009;40:1168-1175.
60. Silva EG, Young RH. Endometrioid neoplasms with clear cells: a report of 21 cases in which the alteration is not of typical secretory type. Am J Surg Pathol. 2007;31:1203-1208. (Pubitemid 47207124)
61. Lax SF, Pizer ES, Ronnett BM, et al. Clear cell carcinoma of the endometrium is characterized by a distinctive profile of p53, Ki-67, estrogen, and progesterone receptor expression. Hum Pathol. 1998;29:551-558. (Pubitemid 28272707)
62. Reid-Nicholson M, Iyengar P, Hummer AJ, et al. Immunophenotypic diversity of endometrial adenocarcinomas: implications for differential diagnosis. Mod Pathol. 2006;19:1091-1100. (Pubitemid 44106724)
63. Arai T, Watanabe J, Kawaguchi M, et al. Clear cell adenocarcinoma of the endometrium is a biologically distinct entity from endometrioid adenocarcinoma. Int J Gynecol Cancer. 2006;16:391-395.
64. Fadare O, Liang SX. Diagnostic utility of hepatocyte nuclear factor 1-beta immunoreactivity in endometrial carcinomas: lack of specificity for endometrial clear cell carcinoma. Appl Immunohistochem Mol Morphol. 2012, Apr. 10 [Epub ahead of print].
65. Aydin H, Young RH, Ronnett BM, et al. Clear cell papillary cystadenoma of the epididymis and mesosalpinx: immunohistochemical differentiation from metastatic clear cell renal cell carcinoma. Am J Surg Pathol. 2005;29:520-523. (Pubitemid 40411186)
66. Cirisano FD Jr, Robboy SJ, Dodge RK, et al. Epidemiologic and surgicopathologic findings of papillary serous and clear cell endometrial cancers when compared to endometrioid carcinoma. Gynecol Oncol. 1999;74:385-394. (Pubitemid 29439878)
67. Abeler VM, Vergote IB, Kjorstad KE, et al. Clear cell carcinoma of the endometrium. Prognosis and metastatic pattern. Cancer. 1996;78:1740-1747. (Pubitemid 26330902)
68. Silverberg SG, De Giorgi LS. Clear cell carcinoma of the endometrium. Clinical, pathologic, and ultrastructural findings. Cancer. 1973;31:1127-1140.
69. Hamilton CA, Cheung MK, Osann K, et al. Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94:642-646. (Pubitemid 43361894)
70. Lax SF, Kurman RJ. A dualistic model for endometrial carcinogenesis based on immunohistochemical and molecular genetic analyses. Verh Dtsch Ges Pathol. 1997;81:228-232.
71. Christopherson WM, Alberhasky RC, Connelly PJ. Carcinoma of the endometrium: I. A clinicopathologic study of clear-cell carcinoma and secretory carcinoma. Cancer. 1982;49:1511-1523. (Pubitemid 12146934)
72. Abeler VM, Kjorstad KE. Clear cell carcinoma of the endometrium: a histopathological and clinical study of 97 cases. Gynecol Oncol. 1991;40:207-217.
73. Verloop J, van Leeuwen FE, Helmerhorst TJ, et al. Cancer risk in DES daughters. Cancer Causes Control. 2010;21:999-1007.
74. Dallenbach-Hellweg G, Hahn U. Mucinous and clear cell adenocarcinomas of the endometrium in patients receiving antiestrogens (tamoxifen) and gestagens. Int J Gynecol Pathol. 1995;14:7-15.
75. Gadducci A, Cosio S, Spirito N, et al. Clear cell carcinoma of the endometrium: a biological and clinical enigma. Anticancer Res. 2010;30:1327-1334.
76. McMeekin DS, Filiaci VL, Thigpen JT, et al. The relationship between histology and outcome in advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials: a Gynecologic Oncology Group study. Gynecol Oncol. 2007;106:16-22. (Pubitemid 46898605)
77. Hutchesson AC, Dunne F, Bundred NJ, et al. Parathyroid hormone-related protein as a tumour marker in humoral hypercalcaemia associated with occult malignancy. Postgrad Med J. 1993;69:640-642. (Pubitemid 23241579)
78. Lee L, Garrett L, Lee H, et al. Association of clear cell carcinoma of the endometrium with a high rate of venous thromboembolism. J Reprod Med. 2009;54:133-138.
79. Kurman RJ, Scully RE. Clear cell carcinoma of the endometrium: an analysis of 21 cases. Cancer. 1976;37:872-882.
80. Clement PB, Young RH. Non-endometrioid carcinomas of the uterine corpus: a review of their pathology with emphasis on recent advances and problematic aspects. Adv Anat Pathol. 2004;11:117-142.
81. Lim D, Oliva E. Nonendometrioid endometrial carcinomas. Semin Diagn Pathol. 2010;27:241-260.
82. Fadare O, Liang SX, Ulukus EC, et al. Precursors of endometrial clear cell carcinoma. Am J Surg Pathol. 2006;30:1519-1530. (Pubitemid 44808788)
83. Lax SF. Molecular genetic changes in epithelial, stromal and mixed neoplasms of the endometrium. Pathology. 2007;39:46-54.
84. Sherman ME, Bur ME, Kurman RJ. p53 in endometrial cancer and its putative precursors: evidence for diverse pathways of tumorigenesis. Hum Pathol. 1995;26:1268-1274.
85. Fadare O, Renshaw IL, Liang SX. Does the loss of ARID1A (BAF-250a) expression in endometrial clear cell carcinomas have any clinicopathologic significance? A pilot assessment. J Cancer. 2012;3:129-136.
86. Bartosch C, Manuel Lopes J, Oliva E. Endometrial carcinomas: a review emphasizing overlapping and distinctive morphological and immunohistochemical features. Adv Anat Pathol. 2011;18:415-437.
87. Sherman ME, Bitterman P, Rosenshein NB, et al. Uterine serous carcinoma. A morphologically diverse neoplasm with unifying clinicopathologic features. Am J Surg Pathol. 1992;16:600-610.
88. Egan JA, Ionescu MC, Eapen E, et al. Differential expression of WT1 and p53 in serous and endometrioid carcinomas of the endometrium. Int J Gynecol Pathol. 2004;23:119-122. (Pubitemid 38391770)
89. Kobel M, Kalloger SE, Santos JL, et al. Tumor type and substage predict survival in stage I and II ovarian carcinoma: insights and implications. Gynecol Oncol. 2010;116:50-56.
90. Carcangiu ML, Chambers JT. Early pathologic stage clear cell carcinoma and uterine papillary serous carcinoma of the endometrium: comparison of clinicopathologic features and survival. Int J Gynecol Pathol. 1995;14:30-38.
91. Vang R, Kempson RL. Perivascular epithelioid cell tumor (PEComa') of the uterus: a subset of HMB-45-positive epithelioid mesenchymal neoplasms with an uncertain relationship to pure smooth muscle tumors. Am J Surg Pathol. 2002;26:1-13. (Pubitemid 34019987)
92. Silva EG, Deavers MT, Bodurka DC, et al. Uterine epithelioid leiomyosarcomas with clear cells: reactivity with HMB-45 and the concept of PEComa. Am J Surg Pathol. 2004;28:244-249. (Pubitemid 38124734)
93. Atkins KA, Arronte N, Darus CJ, et al. The Use of p16 in enhancing the histologic classification of uterine smooth muscle tumors. Am J Surg Pathol. 2008;32:98-102.
94. Oliva E, Young RH, Amin MB, et al. An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am JSurgPathol. 2002;26:403-412. (Pubitemid 34280112)
95. Herbst AL, Ulfelder H, Poskanzer DC. Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. N Engl J Med. 1971;284:878-881.
96. Melnick S, Cole P, Anderson D, et al. Rates and risks of diethylstilbestrol-related clear-cell adenocarcinoma of the vagina and cervix. An update. NEngl J Med. 1987;316:514-516. (Pubitemid 17035554)
97. Herbst AL, Anderson S, Hubby MM, et al. Risk factors for the development of diethylstilbestrol-associated clear cell adenocarcinoma: a case-control study. Am J Obstet Gynecol. 1986;154:814-822. (Pubitemid 16104402)
98. Waggoner SE, Anderson SM, Van Eyck S, et al. Human papillomavirus detection and p53 expression in clear-cell adenocarcinoma of the vagina and cervix. Obstet Gynecol. 1994;84:404-408. (Pubitemid 24267300)
99. Houghton O, Jamison J, Wilson R, et al. p16 Immunoreactivity in unusual types of cervical adenocarcinoma does not reflect human papillomavirus infection. Histopathology. 2010;57:342-350.
100. Pirog EC, Kleter B, Olgac S, et al. Prevalence of human papillomavirus DNA in different histological subtypes of cervical adenocarcinoma. Am J Pathol. 2000;157:1055-1062.
101. Hanselaar A, van Loosbroek M, Schuurbiers O, et al. Clear cell adenocarcinoma of the vagina and cervix. An update of the central Netherlands registry showing twin age incidence peaks. Cancer. 1997;79:2229-2236. (Pubitemid 27227389)
102. Herbst AL. Behavior of estrogen-associated female genital tract cancer and its relation to neoplasia following intrauterine exposure to diethylstilbestrol (DES). Gynecol Oncol. 2000;76:147-156. (Pubitemid 30067188)
103. Reich O, Tamussino K, Lahousen M, et al. Clear cell carcinoma of the uterine cervix: pathology and prognosis in surgically treated stage IB-IIB disease in women not exposed in utero to diethylstilbestrol. Gynecol Oncol. 2000;76:331-335. (Pubitemid 30131503)
104. Evans H, Yates WA, Palmer WE, et al. Clear cell carcinoma of the sigmoid mesocolon: a tumor of the secondary mullerian system. Am J Obstet Gynecol. 1990;162:161-163. (Pubitemid 20055441)
105. Lee KR, Verma U, Belinson J. Primary clear cell carcinoma of the peritoneum. Gynecol Oncol. 1991;41:259-262.
106. Tziortzioti V, Apessou D, Antoniou S, et al. Clear cell adenocarcinoma of the peritoneum associated with clear cell adenocarcinoma arising in an endometrial polyp. J Obstet Gynaecol. 1999;19:557-558. (Pubitemid 29433412)
107. Ichimura T, Ishiko O, Nishimura S, et al. Primary peritoneal clear cell carcinoma: excellent results from paclitaxel and carboplatin combination chemotherapy. Oncol Rep. 2001;8:1243-1245. (Pubitemid 33758722)
108. Terada T, Kawaguchi M. Primary clear cell adenocarcinoma of the peritoneum. Tohoku J Exp Med. 2005;206:271-275. (Pubitemid 40895034)
109. Takano M, Yoshikawa T, Kato M, et al. Primary clear cell carcinoma of the peritoneum: report of two cases and a review of the literature. Eur J Gynaecol Oncol. 2009;30:575-578.
110. Fujiu K, Miyamoto H, Hashimoto S, et al. A case of diaphragmatic clear cell carcinoma in a patient with a medical history of ovarian endometriosis. Int J Clin Oncol. 2010;15:489-492.