2016 Volume 55 Issue 3 Pages 174-178
Background : Large cell neuroendocrine carcinoma (LCNEC) is a rare malignancy. We report herein on a case of LCNEC of the endometrium.
Case : A 73-year-old woman, gravid 4 para 3, visited our hospital to undergo a gynecological examination. Her past medical history was breast cancer and MDS. Cytologic specimens of the endometrium were positive, and biopsy specimens suggested carcinoma. The tumor marker was negative. CT and MRI revealed a mass in the uterus and adnexa, peritoneal dissemination, and swelling of the para-aortic lymph nodes. Therefore, semiradical hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy were undertaken, and debulking of the peritoneal dissemination was performed. Macroscopic examination revealed a tumor of the uterus 32×28 mm in diameter. Microscopically, the tumor had infiltrated the full thickness of the myometrium of the uterine serosa, and had involved the left adnexa and omentum. Extensive vascular invasion was present. Tumor cells showed the features of neuroendocrine differentiation (nesting, rosettes) with polygonal and hyperchromatic nuclei. On immunohistochemical analysis, the tumor cells were positive for synaptophysin and CD56. The final diagnosis was LCNEC of the endometrium, the FIGO stage was IVB. Postoperatively, the patient was started on chemotherapy with irinotecan, and to date has had no recurrence.
Conclusion : LCNEC of the endometrium is very rare. Pathologic finding and immunohistochemistry are important when making a diagnosis.
