Primary Neuroendocrine Carcinoma of the Uterine Cervix Treated With Complete Surgical Resection and Adjuvant Combination Chemotherapy

We describe our experience with one case of cervical large cell neuroendocrine carcinoma (LCNC), with an attempt of an adjuvant chemotherapy after complete surgery. The patient was a 66-year-old female (gravida 3, para 2) presenting with genital bleeding. A cervical mass was diagnosed as high-grade neuroendocrine carcinoma. Radical hysterectomy, pelvic lymph node dissection and bilateral salpingo-oophorectomy were performed as primary treatment for the cervical cancer. The surgical specimen of the uterus had an enlarged cervix of 4 cm in diameter with parametrial invasion. Microscopically, the surgical specimen exhibited invasive proliferation of relatively large tumor cells. Peripheral nuclear palisading and central necrosis were also histologically observed. Tumor cells had abundant cytoplasm with vesicular nuclei. The final pathological conclusion was high-grade neuroendocrine carcinoma (LCNC). The postoperative diagnosis was cervical cancer, high-grade neuroendocrine carcinoma (LCNC), pT2bN0M0, FIGO stage IIB, ly (+), v (+). Adjuvant treatment with cisplatin and irinotecan was planned at 4-week intervals. With the completion of three cycles of adjuvant chemotherapy, there was no evidence of recurrent disease. We determined the adjuvant therapy to be effective and well tolerated, and the therapy is now planned to be continued. In conclusion, we experienced a rare case of uterine cervical LCNC. It was surgically resected completely, and adjuvant chemotherapy has been continued. Adjuvant combination chemotherapy with cisplatin and irinotecan is expected to improve the prognosis of cervical LCNC. J Clin Gynecol Obstet. 2017;6(1):23-27 doi: https://doi.org/10.14740/jcgo432w