VULVAL AND VAGINAL ADENOSIS

Vaginal adenosis is defined by the presence of metaplastic cervical or endometrial epithelium within the vaginal wall, thought to be derived from persistent Mullerian (synonymous with paramesonephric) epitheliu m islets in postembryonic life. Spontaneous vaginal adenosis appears t o be a fairly common (present in about 10% of adult women) but mostly insignificant coincidental finding. In women prenatally exposed to die thylstilboestrol (DES), vaginal adenosis may arise in up to 90% and is associated with a high risk of vaginal carcinoma. Since the withdrawa l of DES from the market, vaginal adenosis has virtually disappeared f rom the medical literature. A case of vaginal adenosis is presented in a middle-aged woman who had not been prenatally exposed to DES. The l esions differed from the spontaneous type by their sudden appearance, their extent and their pronounced.subjective symptoms. It is speculate d that protracted oral contraceptive intake may have played a causativ e role.