Neuroendocrine tumors of the gynecologic tract update

Winer, Ira; Kim, C.; Gehrig, P.A.

doi:10.1016/j.ygyno.2021.04.039

Cited by 31 publications

(52 citation statements)

References 70 publications

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“…The consensus meeting framed the uniform classification for NENs, published in the 2018 WHO classification guide. The updated fifth edition WHO classification of gynecologic NEN is delineated in Table 1 and in-general grading criteria for NENs in Table 2 [ 8 ]. Grading of tumors is based on the Ki-67 index, mitotic index, and tumor characteristics such as necrosis [ 16 ].…”

Section: Nomenclaturementioning

confidence: 99%

“…NENs of the ovary are classified into ovarian carcinoids (grade 1) and ovarian NEC (grade 3). Except for the ovaries, the terms carcinoid and atypical carcinoid were removed from the nomenclature; instead, these correspond to NETs in the updated classification [ 8 , 19 ].…”

Section: Nomenclaturementioning

confidence: 99%

“…Low-grade (G1) tumors have ≤3 Ki-67 and 2/10 HPF mitotic indices, and include typical carcinoids, while intermediate-grade (G2) NETs (Ki-67 >3% and mitotic index 2–20/10HPF) include prior atypical carcinoid variants. In contrast, high-grade NECs have >20 Ki and >20/10 HPF mitotic indices, and include small and large cell NECs [ 8 ]. The small cell variant is the most common (80%) variant among cervical NENs, followed by large-cell NEC (12%) and differentiated (G1–G2) cervical NETs.…”

Section: Cervical Nenmentioning

confidence: 99%

“…CD56 and synaptophysin are the most sensitive markers; however, CD56 lacks specificity due to its wide occurrence in cervical neuroendocrine and non-neuroendocrine neoplasms [ 46 ]. Chromogranin is the most specific marker for cervical NEN [ 8 ]. Other markers studied in the literature include TTF1, p16, and insulinoma-associated protein-1 (INSM1).…”

Section: Cervical Nenmentioning

confidence: 99%

“…Primary gynecologic NENs constitute ≤2% of female reproductive tumors [ 8 ]. In a study by Crane et al, the origin of these neoplasms was 54% in the cervix, 24% in the uterine corpus, 16% in the ovary/fallopian tube, 5% in the vagina, and 1% in the vulva of the study participants [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Neuroendocrine Neoplasms of the Gynecologic Tract

Virarkar

Vulasala

Morani

et al. 2022

Cancers

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Gynecological tract neuroendocrine neoplasms (NEN) are rare, aggressive tumors from endocrine cells derived from the neuroectoderm, neural crest, and endoderm. The primary gynecologic NENs constitute 2% of gynecologic malignancies, and the cervix is the most common site of NEN in the gynecologic tract. The updated WHO classification of gynecologic NEN is based on the Ki-67 index, mitotic index, and tumor characteristics such as necrosis, and brings more uniformity in the terminology of NENs like other disease sites. Imaging plays a crucial role in the staging, triaging, restaging, and surveillance of NENs. The expression of the somatostatin receptors on the surface of neuroendocrine cells forms the basis of increasing evaluation with functional imaging modalities using traditional and new tracers, including 68Ga-DOTA-Somatostatin Analog-PET/CT. Management of NENs involves a multidisciplinary approach. New targeted therapies could improve the paradigm of care for these rare malignancies. This article focuses on the updated staging classifications, clinicopathological characteristics, imaging, and management of gynecologic NENs of the cervix, ovary, endometrium, vagina, and vulva, emphasizing the relatively common cervical neuroendocrine carcinomas among these entities.

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Section: Nomenclaturementioning

confidence: 99%

Section: Nomenclaturementioning

confidence: 99%

Section: Cervical Nenmentioning

confidence: 99%

Section: Cervical Nenmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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