2006 Volume 45 Issue 2 Pages 121-124
Background: The incidence of small cell carcinoma of the uterine cervix is 5% or less of all uterine cervical cancers. We report an extremely rare case of a small cell carcinoma with syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Case: A 41-year-old woman developed behavior changes thought to be due to an ectopic hormone-producing tumor. No tumor was detected by thoracoabdominal computed tomography. A colposcopic examination revealed a protruding tumor in the uterine cervix. Brush cytology showed atypical small cells assembled in nests with a loose arrangement. The tumor cells had scant cytoplasm, except for spottedly acidophilic ones. Imprint cytology performed during surgery revealed spotty tumor clusters forming a molding pattern. Histologically, the tumor was proliferative with a solid architecture of atypical small cells with rosette and ribbon-like arrangements and foci of squamous differentiation. Immunohistochemical studies of the tumor produced positive findings for chromogranin A and synaptophysin. Electron microscopy revealed that the cytoplasm contained membrane-bound electron-dense neurosecretory granules.
Conclusion: A functioning small cell carcinoma of the uterine cervix with a poor prognosis is very rare. Clinically, early confirmation of this diagnosis is necessary. Brush and imprint cytology were very useful for determining the localization and characterization in the present ease because the patient had neither symptoms of the uterine cervix nor high titers of common tumor markers.
