1997 Volume 36 Issue 2 Pages 233-237
Neuroendocrine carcinoma is a rare tumor in the uterine cervix. We report a case of small cell neuroendocrine carcinoma arising in the cervix of a 30-year-old, pregnant (29 weeks) female. A ping-pong ball-sized tumor was detected when the patient visited a physician complaining of abnormal genital bleeding. Radical hysterectomy was performed, followed by high dose chemotherapy and peripheral blood stem cell transplantation. However, she died due to the complication of bone marrow suppression at 7 months postoperatively. The cervical smear showed small atypical cells with scant cytoplasm which were scattered individually or aggregated in small clusters against a necrotic background. Microscopically, small tumor cells were arranged in nests, cell cords and a ribbon pattern, and contained argyrophilic granules as demonstrated by the Grimelius method. Immunohistochemically, tumor cells were positive for chromogranin A, neuron specific enolase and synaptophysin. Therefore, the tumor was diagnosed as small cell neuroendocrine carcinoma of the uterine cervix. It is mandatory to distinguish this type of tumor from small cell, non-keratinizing squamous cell carcinoma or poorly differentiated adenocarcinoma, in that small cell neuroendocrine carcinoma is more aggressive and requires more intensive therapy. Cytologic examination is important in the differential diagnosis of this tumor.
