Incidentally detected neuroendocrine carcinoma of the cervix in a young female: A rare case report with literature review

Abstract

Background: Small-cell neuroendocrine carcinoma (SCNEC) of the cervix is a rare malignancy with aggressive behaviour and poor prognosis, comprising < 2% of cervical cancers [1-3]. They are more frequent in India compared to western countries, and in younger age groups. Case: We report a 33-year-old woman who underwent hysterectomy for presumed fibroid uterus. Postoperative histopathology revealed high-grade SCNEC, FIGO Stage IB2, with margin positivity and lymphovascular space invasion (LVSI). Immunohistochemistry confirmed neuroendocrine differentiation. Multidisciplinary tumour board consensus was for adjuvant chemoradiation with weekly cisplatin. In view of paucity of guidelines, patient received radiotherapy as per guidelines for Squamous cell carcinoma cervix. Conclusion: SCNEC is a rare presentation in cervix with non-specific symptoms and imaging findings. A high clinical suspicion and immunohistochemistry are pivotal for diagnosis. SCNEC have early hematogenous spread, high recurrence rates, and poor survival outcomes compared with squamous and adenocarcinoma cervical cancers, and hence early diagnosis and aggressive multimodal treatment are of paramount importance.