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Case Reports
. 2024 Dec 5;16(12):e75144.
doi: 10.7759/cureus.75144. eCollection 2024 Dec.

Rare Becomes Rarer: Neuroendocrine Carcinoma of the Cervix With Synchronous Breast, Pancreatic, and Ovarian Metastases

Luís Guilherme Santos  1 , Ricardo Roque  1 , Rita Antunes Santos  1 , Tatiana Pereira  1 , Isabel Pazos  1
Affiliations
Case Reports

Rare Becomes Rarer: Neuroendocrine Carcinoma of the Cervix With Synchronous Breast, Pancreatic, and Ovarian Metastases

Luís Guilherme Santos et al. Cureus. .

Abstract

Neuroendocrine carcinoma of the cervix (NECC) is a rare and extremely aggressive disease. Treatment options are scarce (mainly consisting of platinum-based chemotherapy combinations), and randomized controlled trials are lacking, leading to a very poor prognosis. It is prone to early metastasis, often with more than one affected site at diagnosis. The lung, liver, brain, and bone are the most frequent sites. We present the case of a 33-year-old female patient with no significant medical history. Postcoital bleeding led to the diagnosis of human papillomavirus (HPV)-related NECC after a tissue biopsy of a cervical mass. Disease staging showed suspected metastasis on the breast, pancreas, and ovaries, each of which is very rarely described in the literature. Both the breast and ovarian metastases were histologically confirmed through biopsy, while pancreatic metastases were deemed highly likely based on radiological findings. The patient was started on first-line chemotherapy with significant toxicities and rapid disease progression and is currently on third-line chemotherapy treatment. To our knowledge, this is the first reported case of these very rare sites of metastasis from NECC being present simultaneously, highlighting the complexity of this challenging entity.

Keywords: breast metastasis; neuroendocrine carcinoma of cervix; ovarian metastasis; pancreatic metastasis; rare cancers.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Abdominopelvic MRI
(A) Abdominopelvic MRI showing a posterior-lateral cervical mass (red arrow) and concomitant, extensive, heterogenous, mainly cystic mass (green arrow) apparently arising from the left ovary; (B) abdominal MRI showing pancreatic edema with multiple nodular lesions compatible with metastasis from the extra-pancreatic site.
Figure 2
Figure 2. Mammogram
Mammogram showing a lesion on the right breast (red arrow).
Figure 3
Figure 3. Abdominal MRI
This MRI shows disease progression on first-line treatment. The mass previously visible arising from the left ovary (green arrow) now extends far beyond the pelvic cavity and into the abdomen. A cervical mass is also still present.
See this image and copyright information in PMC

References

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