Types
Cervical Cervical adenocarcinoma is less likely to be caused by high-risk HPV strains than cervical squamous cell carcinoma is: around 10-15% of cervical adenocarcinomas are non-HPV-related. Cervical clear cell carcinoma (CCC) is typically HPV-negative, though many are p16 positive. Traditionally, clear cell carcinoma of the lower genital tract in females was related to diethylstilbestrol (DES) exposure in utero. More recently, these cases develop sporadically or are related to vaginal adenosis. Risk factors are similar to other types of cervical cancer, including immunosuppression, smoking, long-term oral contraceptive use, increased number of sexual partners, early onset of sexual activity, hormone replacement therapy, and obesity. Ovarian Ovarian clear cell carcinoma is a subtype of epithelial ovarian carcinoma. These tumors are typically unilateral. They are associated with endometriosis, in which endometrial tissue grows outside the uterine cavity. Benign endometriotic cysts, also known as adenofibromas, are frequently the source of these tumor cells. Treatment of ovarian clear cell carcinoma typically begins with surgery to remove the ovaries and other affected organs. Chemotherapeutic treatment of gynecological cancers typically includes a platinum-based therapy and a taxane. Clear cell ovarian tumors have a higher rate of resistance to these medications. Other treatment routes, including immunologic agents against certain biomarkers, are being explored. Uterine Uterine clear cell carcinoma is a rare, aggressive form of endometrial cancer. This is an example of a Type II endometrial carcinoma, meaning that it is unrelated to endometrial hyperplasia. Uterine clear cell tumors arise from an endometrium that has become thin and dry. Patients usually present with abnormal uterine bleeding. Treatment of uterine clear cell carcinoma is primarily surgical. A tumor debulking procedure is typically performed, consisting of a total hysterectomy and bilateral salpingo-oopherectomy. Depending on the level of tumor invasion, an omentectomy and other malignancy removal may be performed at the same time. Cytoreductive surgery, which involves removing all visible cancer cells during the operation, is the current standard of care. Minimally invasive surgical techniques are preferred over open surgeries, as patients tend to have better short-term outcomes after the surgery. Patients may be treated with chemotherapy or radiation following tumor debulking. Platinum-based chemotherapy is the mainstay for most gynecologic cancers, including endometrial cancers. Depending on the genomic subtype of the tumor, various other chemotherapeutic or immunologic therapies may be employed. Vaginal clear cell carcinoma frequently presents with abnormal uterine bleeding. As with other gynecological cancers, treatment varies with the stage of the cancer. Lower grade tumors can be treated with surgical resection, while higher grade tumors may need chemotherapy and radiation. == See also ==