Large Cell Neuroendocrine Carcinoma of the Uterine Cervix

Abstract

Six cases of cervical large cell neuroendocrine carcinomas (LCNEC) were found among 972 patients (0.6%) with invasive cervical carcinoma. The patients, who were from 27 to 51 (mean 38) years of age, presented with vaginal bleeding or an abnormal Papanicolaou smear. Five tumors were stage Ib and one was IIa. All patients underwent radical hysterectomy and received adjuvant chemotherapy and pelvic radiotherapy. Four patients died of tumor 6 to 19 months (mean 14 months) postoperatively. On histologic examination, the tumor cells were arranged in an organoid growth pattern and were larger than those of typical small cell carcinoma. Glandular differentiation was present in one case. Mitotic figures ranged from 15 to 45 (mean 29) per 10 high-power fields. Prominent vascular invasion and necrosis was seen in all of the tumors. Each tumor was immunoreactive for chromogranin A and/or synaptophysin. The results of this study confirm the aggressive nature of cervical LCNECs. The recognition of LCNECs is necessary to establish the most effective treatment for these aggressive tumors.

Twelve Cases of Neuroendocrine Carcinomas of the Uterine Cervix: Cytology, Histopathology and Discussion of Their Histogenesis

“…Then, (1) the hyperplasia of NE cells leads to NEC accompanied by EGD, (2) the malignant transformation of only the glandular epithelium leads to AIS or invasive adenocarcinoma, sometimes accompanied by increasing NE cells, and (3) both the hyperplasia of NE cells and the malignant transformation of the glandular epithelium lead to NEC combined with AIS or invasive adenocarcinoma. These phenomena are reported here and in some other documents [17,18,19,20]. However, the hypothesis needs to be further confirmed by molecular mechanism studies.…”

Rapidly progressing large-cell neuroendocrine carcinoma arising from the uterine corpus: A case report and review of the literature

“…The histological characteristics of LCNEC of the endometrium include cells with abundant cytoplasm, microgranular chromatin, clear nucleolus, polymorphism with various sizes, multinucleated cells, large tumor cells, ≥10 mitoses/high-power field, map-like hemorrhage and necrosis, island-like or columnar tumor cell aggregates and vascular invasion (7,8). On immunostaining, the tumor cells stained positive for synaptophysin, chromogranin A, CD56, p53 and NSE, confirming the diagnosis of LCNEC (15)(16)(17)(18).…”

High-Grade Neuroendocrine Carcinoma of the Cervix

“…In another study aimed to evaluate the clinical and pathologic factors associated with survival of patients with neuroendocrine cervical carcinomas, it was stated that the role of primary or postoperative radiation with or without chemotherapy is unclear and yields uniformly poor results, particularly in patients with advanced lesions [13] . Many of the cases in the literature are reported to be very invasive and have distant spread together with metastases to regional lymph nodes [14][15][16][17][18][19][20] . This great tendency to have distant and locoregional metastases makes the treatment of this tumor type very diffi cult.…”