Definitive radiation therapy for an elderly Japanese patient with advanced clear cell adenocarcinoma of the uterine cervix: a rare case report and review of the literature

Cervical clear cell adenocarcinoma is rare in Japanese patients, and such patients are generally older than those from other countries. We herein describe a case involving radiation therapy for cervical clear cell adenocarcinoma in the most elderly patient reported to date. An 84-year-old Japanese woman presented with lower abdominal pain. Magnetic resonance imaging and colposcopy revealed hematometra and a mass in the uterine cervix. Examination of a biopsy specimen showed invasive growth of cancer cells with glycogen-positive clear cytoplasm. Immunohistochemical examination revealed expression of hepatocyte nuclear factor 1-beta in the nucleus, resulting in a diagnosis of clear cell adenocarcinoma. Radiation therapy comprised external irradiation and high-dose-rate remote afterloading brachytherapy. Upon treatment completion, multiple pulmonary metastases and peritoneal dissemination were observed, but the primary tumor exhibited a complete response 1 month after radiation therapy. We conclude that pelvic radiation therapy and brachytherapy can be safely administered to elderly Japanese patients with cervical clear cell adenocarcinoma.