Vaginal clear cell adenocarcinoma with early pulmonary metastasis in a child.

Although a few cases of vaginal clear cell adenocarcinoma (CCAC) have been reported in the ages under 14, they have presented in a much more aggressive form than the CCAC cases in higher ages and parenchymal pulmonary metastasis are known to occur following the primary tumor. This is a case report of a primary vaginal CCAC in an 8.6-year-old girl with no history of DES exposure who presented with vaginal bleeding and abdominal pain and the imaging signs of pulmonary metastasis at the presentation. Diagnostic imaging modalities should be considered for any child complaining of vaginal bleeding, due to limitation of vaginal examination. Chest X-ray is recommended at the time of diagnosis of CCAC and at follow-up sessions for early diagnosis of pulmonary metastasis.