Oct. 16, 2017—The embryological origin of the human vagina has remained contested for more than 80 years. In a new study led by Stanley J. Robboy, MD, and published in Differentiation (2017;97:9–22), the analysis definitively concluded that while the vagina’s muscular wall is Müllerian in origin, the epithelium that comes to line the wall beginning in the middle of the pregnancy consists of cells of endodermal origin that have ingrown from the embryonic urogenital sinus.
This investigation offers for the first time a mechanism for how the malignancy, clear cell adenocarcinoma, and its precursor and benign condition, vaginal adenosis, could arise in young women several decades after they were exposed in utero to the drug, diethylstilbestrol (DES), that their mothers had taken during their pregnancies, Dr. Robboy tells CAP TODAY.
During his years at Massachusetts General Hospital, he says, he examined a number of the cancer cases. “I am already in the process of trying to identify those cases and examine them using the new stains developed over these past years to support or disprove the mechanism advanced,” he says.