Clear Cell Carcinoma of the Uterine Cervix in a 14-Year-Old Girl: A Case Report.

Clear cell carcinoma of the uterine cervix is a rare subtype. We report the case of a 14-year-old girl who presented with abnormal genital bleeding, a 7 cm mass arising from the uterine cervix, and swollen right inguinal lymph nodes. Histological and immunohistochemical examinations showed clear cell carcinoma. We performed a modified-radical hysterectomy, bilateral salpingo-oophorectomy, right inguinal lymph node biopsy, bilateral pelvic lymph node biopsy, and para-aortic lymph node biopsy, and diagnosed uterine cervical cancer stage IVB (clear cell carcinoma, pT2bN2M1). We administered paclitaxel-carboplatin+bevacizumab+pembrolizumab as adjuvant chemotherapy. Pembrolizumab is an immune checkpoint inhibitor associated with characteristic adverse events called immune-related adverse events (irAEs). In this case, arthritis and autoimmune pancreatitis were observed as irAEs during the treatment, but the patient was able to continue treatment. There is limited clinical experience with immune checkpoint inhibitors for pediatric patients. When remission is achieved, a better long-term prognosis is expected than in adults, so it is necessary to follow up with attention to late-onset irAEs.