Clinicopathological features and prognosis of small cell carcinoma of the cervix

Abstract

Small cell carcinoma of cervix (SCCC) is a rare disease with highly aggressive behaviour and is pathologically hard to diagnose. In this study, the clinicopathological features, diagnosis, treatment and prognosis of the condition were examined. Clinical records and follow-up data of 7 cases of SCCC were retrospectively studied. Our results showed that five non-recurrent cases initially presented irregular vaginal bleeding or increased apocenosis of varying degrees. Pathological examination revealed that the stroma was diffusely infiltrated with small monomorphous cells ranging from round to oval shape. Three cases were immunohistochemically confirmed. One case was accompanied with squamous cell cancer. Of the 7 cases, one case was classified as stage I b1, two stage I b2, one stage IIa, one stage IIb, and one stage IIIb. On the basis of their stages of condition, one subject with stage III b underwent chemotherapy, and one with stage Ib2 received extensive hysterectomy plus pelvic lymphadenectomy, while the other 5 cases were treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy. Of the 7 patients, 4 had relapse-free survival of 14, 14, 16 and 28 months respectively. It is concluded that SCCC is an aggressive tumor with propensity for early pelvis lymph node metastases. Early-stage patients should be treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy.

Adjuvant Chemotherapy, a Valuable Alternative Option in Selected Patients with Cervical Cancer

“…However, the major concern with using chemotherapy alone is that local recurrence may increase in the absence of radiotherapy. Some patients who underwent primary radical hysterectomy were found to have HRFs for local recurrence, including LNM and parametrial invasion [37]–[39]. The data in the present study did not show any differences in the 5-year OS or DFS rates between the chemotherapy and radiotherapy groups (Fig.…”

Small cell neuroendocrine carcinoma of the uterine cervix presenting with syndrome of inappropriate antidiuretic hormone secretion

“…The light microscopy and immunohistochemical staining are used for diagnosis of the disease and the tumor cells behave similarly to the lung [6]. When immunohistochemically stained, they are positive for general neuroendocrine markers including synaptophysin, chromogranin A, neuron-specific enolase, and CD 56 [10]. …”

Chronic inflammatory demyelinating polyneuropathy, diagnosed as a paraneoplastic manifestation of small cell neuroendocrine carcinoma of the cervix

“…17 Early-stage patients should be treated with extensive hysterectomy and pelvic lymphadenectomy in combination with pre-and/or postoperative adjuvant chemotherapy and radiotherapy. 6,11 Concurrent chemoradiation could be used to treat patients with advancedstage disease, despite their poor prognosis. 11 Use of adjuvant chemotherapy or chemoradiation has been associated with higher survival in patients with small cell neuroendocrine cervical cancer.…”

“…Small cell neuroendocrine carcinoma of the cervix carries a dismal prognosis with high mortality, even with early-stage disease that relates to early nodal and haematogenous metastasis. [4][5][6][7][8] Even though it is a highly aggressive neoplasm, early diagnosis and combined therapeutic modalities may lead to longer survival in some patients. 9 Use of adjuvant chemotherapy or chemoradiation has been associated with higher survival in patients with cervical cancer.…”