Small cell carcinoma of the cervix: a case report

Abstract

Small cell carcinoma of the uterine cervix accounts for 1-3% of all cervix cancers. It is an aggressive disease with a poor prognosis. To date, no effective treatment protocol has been determined. Surgery, radiotherapy, and chemotherapy have been used either alone or in combination. Recent data suggests that survival in patients with early staged small cell carcinoma of the cervix is better with surgery combined with chemo-radiotherapy. Here, we presented two patients with stage IB1 small cell carcinoma of the uterine cervix. For both patients, definitive surgery was performed with pelvic and para-aortic lymphadenectomy. Subsequently, they were treated with pelvic external radiotherapy and high-dose-rate intracavitary brachytherapy with concurrent cisplatin based chemotherapy. They were alive with no evidence of disease at 91 and 65 months, respectively.

Small Cell Carcinoma of the Uterine Cervix Misdiagnosed as Squamous Cell Carcinoma

“…The uterine cervix is the most common site in the female genital tract for the occurrence of small cell carcinoma which accounts for up to 2% of all cervical carcinomas (Korcum, 2008;Gardner, 2011). The etiology and pathogenesis of SCNCC are unknown; some reports suggest that it might be strongly associated with human papilloma virus type 18 or 16 or with a high frequency of mutation of the p53 tumor suppressor gene (Korcum, 2008).…”

“…The etiology and pathogenesis of SCNCC are unknown; some reports suggest that it might be strongly associated with human papilloma virus type 18 or 16 or with a high frequency of mutation of the p53 tumor suppressor gene (Korcum, 2008). Median age of diagnosis is in the fifth decade (Gardner, 2011).…”

“…Therefore, the treatment of SCNCC takes into account both treatment options for cervical squamous cell cancer and small cell lung cancer at the same time. One important point is that pelvic control alone is not usually enough to reach a better survival rate due to the early spread of the disease (Boruta, 2001;Korcum, 2008;Bifulco, 2009), thus controlling hematogenous spread is and should be a necessity (Bifulco, 2009). A multidisciplinary therapy, including surgery, chemotherapy and radiotherapy is mandatory (Korcum, 2008;Bifulco, 2009;Gardner, 2011;Nasu, 2011).…”

“…Its histology and clinical behavior are comparable to that of small cell carcinoma (SCC) of the lung (Korcum, 2008). SCNCC is characterized by an aggressive clinical course and poor prognosis due to the high incidence of lymphatic involvement and hematogenous dissemination occurring at an early stage (Korcum, 2008;Abeler, 1994;Hoskins, 1995). Therefore, the prognosis of SCNCC is worse when compared to the other cervical malignancies.…”

“…Therefore, the prognosis of SCNCC is worse when compared to the other cervical malignancies. The treatment is based on surgery, radiotherapy and chemotherapy either alone or in combination (Korcum, 2008;Huang, 2006), but a standard treatment protocol is still to define due to the rarity of this entity. Herein, we report a case of SCNCC misdiagnosed initially as squamous cell carcinoma, and review and discuss the clinical course and the modalities of treatment.…”