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. 2018 Nov;9(5):519-522.
doi: 10.3892/mco.2018.1717. Epub 2018 Sep 13.

Challenges in the management of neuroendocrine cervical cancer during pregnancy: A case report

Blanca Gil-Ibañez  1 , Purificacion Regueiro  2 , Elisa Llurba  3 , Lorena Fariñas-Madrid  4 , Angel Garcia  5 , Berta Diaz-Feijoo  6
Affiliations

Challenges in the management of neuroendocrine cervical cancer during pregnancy: A case report

Blanca Gil-Ibañez et al. Mol Clin Oncol. 2018 Nov.

Abstract

Large-cell neuroendocrine carcinoma (LCNEC) is an uncommon histological subtype of cervical cancer that is associated with poor survival and its occurrence during pregnancy is particularly rare. We herein present the case of a female patient who was diagnosed with cervical LCNEC during pregnancy. The patient declined pregnancy termination and was treated with neoadjuvant chemotherapy with cisplatin and etoposide, without associated toxicity and with good fetal development. At 31.4 weeks of gestation, the fetus was delivered by caesarean section, and the patient underwent radical nerve-sparing hysterectomy with bilateral adnexectomy, along with pelvic and inframesenteric para-aortic lymphadenectomy. The patient received adjuvant chemoradiotherapy and there was no evidence of recurrence or metastasis at 38 months postoperatively. The baby has also been followed up, without any signs of neurodevelopmental disorders. To the best of our knowledge, the present report describes the first case of LCNEC with pregnancy-preserving management in the literature to date.

Keywords: cervical cancer in pregnancy; neoadjuvant chemotherapy; neuroendocrine carcinoma; radical hysterectomy post-caesarean section; uterine cervix.

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Figures

Figure 1.
Figure 1.
On magnetic resonance imaging examination there was no evidence of lymph node involvement or metastatic disease.
Figure 2.
Figure 2.
Intraoperative images during caesarean section performed at 31.4 weeks, with concomitant radical nerve-sparing hysterectomy, bilateral adnexectomy and pelvic and inframesenteric para-aortic lymphadenectomy.
Figure 3.
Figure 3.
The surgical specimen displayed a high-grade cervical large-cell neuroendocrine carcinoma, sized 40×16 mm (inset).
See this image and copyright information in PMC

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