Vaginal clear cell adenocarcinoma in Herlyn-Werner-Wunderlich syndrome: A case report

Figure 1 Imaging of the patient with Herlyn-Werner-Wunderlich syndrome complicated with vaginal clear cell adenocarcinoma. A: Axial T2-weighted magnetic resonance imaging obtained after surgical excision of the oblique vaginal septum demonstrates uterus didelphys with two separate uterine cavities, typical of Herlyn-Werner-Wunderlich syndrome. There are also multiple Nabothian cysts in the cervix; B: Computed tomography scan of the lungs performed 4 years after radical surgery reveals a 1.8 cm nodule located in the anterior segment of the upper lobe of the right lung, suspicious for metastasis (arrow); C: Positron emission tomography/computed tomography scan, also obtained 4 years post-radical surgery, shows increased fluorodeoxyglucose uptake in the right lung nodule, indicative of active metabolic activity and consistent with metastatic disease (arrow).

Figure 2 Hematoxylin and eosin staining (× 40) of the patient's resected vaginal tissue. The image shows benign glands (arrow) adjacent to clear cell adenocarcinoma (short arrows), indicating malignant transformation of vaginal adenosis (arrows).