Neurosurgical management is essential for rare cerebral metastases from non-DES-related vaginal clear cell adenocarcinomaRare Case Shows Brain Metastasis from Vaginal Clear Cell Cancer

Frontiers in Medicine Published September 4, 2026 DOI ↗ Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

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Key Takeaway

Recognize the role of neurosurgery in managing rare cerebral metastases from non-DES-related vaginal clear cell adenocarcinoma.

This case report and review of the literature describes a rare presentation of non-DES-related primary clear cell adenocarcinoma of the vagina (PCCAV) in a 17-year-old female. The patient presented with a vaginal mass and a parietal mass, which was determined to be a metastatic clear cell vaginal adenocarcinoma. CT staging also identified pulmonary metastases.

The authors synthesize the clinical challenge of managing cerebral metastases from these specific tumors. The report emphasizes that while these cases are extremely rare, they require specialized neurosurgical intervention. The authors note that there is a current lack of standardized management guidelines for patients presenting with cerebral metastases from non-DES-related vaginal clear cell tumors.

Clinical practice relevance is centered on the role of neurosurgery in managing intracranial involvement. Because these cases are rare, the report serves to highlight the need for established protocols. The evidence is limited by the small sample size of a single case report, which may not reflect broader clinical trends but underscores a specific management need for rare metastatic sites.

A medical report describes a rare case involving a 17-year-old female diagnosed with non-DES-related primary clear cell adenocarcinoma of the vagina. This specific type of cancer is uncommon, and the case highlights how it can spread to other parts of the body, including the lungs and the brain.

Doctors identified a mass in the vagina and a separate mass in the parietal region of the head. Imaging showed that the cancer had spread to the lungs and the brain. Because this specific type of cancer is rare, and spread to the brain is even rarer, this case provides important information for medical teams.

This report is based on a single case and a review of existing literature. Because it is a single case, the findings are not enough to change standard treatments for everyone. However, it highlights the important role neurosurgery plays in managing brain involvement. It also shows that more standard guidelines are needed for doctors treating these rare tumors.

What this means for you:

A rare case of vaginal cancer spreading to the brain highlights the need for clearer management guidelines.

Common questions

What was found in this specific case?

Doctors identified a case of non-DES-related primary clear cell adenocarcinoma of the vagina in a 17-year-old patient. The cancer was found to have spread to both the lungs and the brain. This specific type of cancer and its spread to the brain are considered very rare occurrences.

What role does neurosurgery play in this condition?

The report highlights the important role that neurosurgery plays in managing cases where vaginal clear cell tumors spread to the brain. Because these cases are rare, the report suggests that more standard management guidelines are needed for doctors to treat these specific types of tumors.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedSep 2026

View Original Abstract ↓

BackgroundCases of primary clear cell adenocarcinoma of the vagina (PCCAV) are infrequently encountered and account for only 5%–10% of all primary vaginal cancers 1. The most common associated risk factor for developing PCCAV is in utero exposure to diethylstilbestrol (DES). Patients with non-DES-related PCCAV are even scarcer and usually have a worse prognosis. PCCAV has been reported to metastasize to the lungs, supraclavicular lymph nodes, and the pelvis, while metastases to the liver, brain, and peritoneum are extremely rare. We present a rare case of a 17-year- old female patient with cerebral metastases from a non-DES-related PCCAV.Case reportA 17-year-old female patient presented to the medical emergency unit at the Chris Hani Baragwanath Academic Hospital with a 2-month history of left-sided weakness, complicated by a 2-week history of generalized tonic–clonic seizures, vomiting, and headaches. Three months before this presentation, she had been experiencing menorrhagia associated with foul vaginal discharge, which was unresponsive to treatment received at peripheral hospitals. Further examination by the gynecology team revealed a vaginal mass which was subsequently biopsied. A CT scan was performed as part of her workup, and the results showed a right contrast-enhancing parietal mass with extensive vasogenic edema, causing significant midline shift.ResultsThe histology from the vaginal mass favored a clear cell vaginal adenocarcinoma, while that from the parietal mass was determined to be a metastatic clear cell vaginal adenocarcinoma. Pulmonary metastases were also noted on CT staging.ConclusionCerebral metastases from non-DES-related vaginal clear cell tumor are extremely rare. Our case adds to the existing body of knowledge, highlights the role of neurosurgery in its management, and demonstrates the need for the development of relevant standard management guidelines.

Neurosurgical management is essential for rare cerebral metastases from non-DES-related vaginal clear cell adenocarcinomaRare Case Shows Brain Metastasis from Vaginal Clear Cell Cancer

Common questions

Study Details

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Neurosurgical management is essential for rare cerebral metastases from non-DES-related vaginal clear cell adenocarcinomaRare Case Shows Brain Metastasis from Vaginal Clear Cell Cancer

Common questions

Study Details

First-line immune checkpoint inhibitor combinations improve overall survival in extensive-stage small-cell lung cancer

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Clinical research that matters. Delivered to your inbox.

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