Primary Vaginal Adenocarcinoma of Intestinal-Type: A Case Report of a Rare Tumor With Review of Histology, Differential Diagnosis, and Literature

Intestinal-type adenocarcinoma is a rare primary vaginal carcinoma. Vaginal adenocarcinomas are most frequently a metastatic lesion, and less commonly, have clear cell histology and occur in young women with diethylstilbestrol (DES) exposure in utero. Due to the limited diagnostic power of immunohistochemistry (IHC) in differentiating primary from metastatic adenocarcinoma of the vagina, clinical and radiological correlation is critical in this scenario. The prognosis of this tumor depends on the patient’s age, tumor stage, tumor differentiation, lymph node status, and distant metastasis. Several treatment modalities are present depending on the tumor stage. We present a case of primary adenocarcinoma of the vagina and describe the histopathologic features including the immunoprofile of the tumor and discuss the clinicopathologic features, differential diagnosis, diagnostic challenges, and a brief overview of the literature about age, size, site, immunohistochemical staining, and DES exposure.