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Table 1 Chronicle of the diagnosis and treatment. HPV, human papillomavirus

From: Malignant transformation of vaginal adenosis to clear cell carcinoma without prenatal diethylstilbestrol exposure: a case report and literature review

Date Procedures of diagnosis and treatment Pathological findings
September 1, 2011 Vaginal biopsy Vaginal adenosis
December 16, 2011 Vulvar biopsy Chronic inflammation; absence of focal epithelial absence; granulation tissue formation
March 4, 2013 Cytology A few atypical glandular cells and high-grade squamous intraepithelial lesion
March 4, 2013 High-risk HPV test Negative
April 10, 2013 Vaginal and cervical biopsy chronic inflammation; cervical intraepithelial neoplasia of grade I
May 10, 2013 Fractional curettage Endometrium of late proliferative phase
March 4, 2015 Cytology Atypical squamous cells: cannot exclude high-grade squamous intraepithelial lesion
March 4, 2015 Vaginal biopsy Vaginal adenosis; moderate atypical hyperplasia of focal squamous epithelium
December 24, 2015 Cytology A few atypical gland cells
December 24, 2015 High-risk HPV test Negative
March 18, 2016 Cytology Suspicious adenocarcinoma of cervix; atypical squamous epithelial cells of vagina
March 3, 2016 Fractional curettage A little cervical canal tissue and endometrium of secretory phase
April 15, 2016 Vaginal biopsy The serous papillary glands with active growth; chronic inflammation
May 4, 2016 Hysterectomy with bilateral salpingoophorectomy, and excision of vaginal lesions Normal findings except atypical vaginal adenosis in the vaginal wall
May 15, 2017 Cytology A few atypical gland cells
May 15, 2017 Biopsy of vaginal stump Serous papillary glands with active growth, which suggested atypical adenosis
August 15, 2017 Excision of vaginal lesions The mass of mid-anterior vaginal wall was confirmed to be clear cell carcinoma
September 15, 2017 Wide local resection of vaginal lesions Atypical vaginal adenosis with negative incision margin
July 18, 2018 Biopsy of vulvar ulcer Chronic inflammation of fibrous tissue and squamous epithelium