A retrospective clinicopathological analysis of small-cell carcinoma of the uterine cervix

Abstract

Cervical cancer encompasses several histological types, including neuroendocrine tumors (NETs). Small-cell carcinoma of the uterine cervix (SCCC) is the most common and aggressive subtype of cervical NET. The objective of this case report was to investigate SCCC using a retrospective clinicopathological approach. Four cases of large (≥4 cm) SCCCs are presented in this case study. The patients were diagnosed with SCCC through a sequential hierarchy of physical examinations, laboratory reports, radiological reports, immunohistochemical and pathological tests. The diagnosis for each case was made at various stages (Ib1, Ib2, IIa2 and IIb, according to the FIGO staging system, 2000) and each of the patients received different multimodality therapeutic regimens. All the patients underwent radical hysterectomy and pelvic lymphadenectomy, followed by adjuvant chemotherapy. Neoadjuvant chemotherapy was administered prior to surgery in two of the patients. The clinical and pathological analyses were assessed using a retrospective measure, maintaining timely follow-ups. SCCC is a rare but serious gynecological malignancy. This condition has a poor prognosis due to its high aggressiveness, high rate of metastases and mortality. Furthermore, the rarity of this disease represents a hindrance to adequate research and development of novel, efficient therapeutic regimens.

Keywords: multimodal treatment regimen; neoadjuvant chemotherapy; prognostic factor; small-cell carcinoma of cervix.

Figure 1.

Resected uterus exhibiting a tumor growth (≥5 cm).

Figure 2.

Histological section of biopsy specimen. Hematoxylin and eosin staining (magnification, ×400). The biopsy demonstrated a dense population of cells with hyperchromatic nuclei and scant cytoplasm, which is similar to the histological characteristics of small-cell carcinoma of the lungs.

Figure 3.

Immunohistochemical finding of biopsy specimens (magnification, ×400). (A) Immunostaining for neuron-specific enolase revealed a positive reaction. (B) Immunostaining showing a positive reaction for synaptophysin. (C) Immunostaining for CD117 showing partial positive reactivity.

Figure 4.

T2-weighted magnetic resonance images of the tumor: (A) tumor after the initial diagnosis and (B) tumor after the patient received 2 cycles of neoadjuvant chemotherapy.