Bifulco Giuseppe, Mandato Vincenzo Dario, Giampaolino Pierluigi, Piccoli Roberto, Insabato Luigi, De Rosa Nicoletta, Nappi Carmine
Department of Gynecology and Obstetrics, and Pathophysiology, Pathology Section, University of Naples 'Federico II', Italy.
Anticancer Res. 2009 Feb;29(2):477-84.
Small cell neuroendocrine cervical carcinoma (SCNCC) is a rare tumor that comprises 1-3% of cervical tumors. SCNCC exhibits clinical and biological characteristics of both cervical neoplasm (such as local aggressiveness and involvement of papillomavirus) and neuroendocrine small cell cancer of any site (such as early dissemination of the disease and loss of heterozygozity at different loci) making it an original nosologic entity. There is no unanimous opinion regarding the optimal management strategy.
A 48-year-old Caucasian woman, para 3, referred postmenopausal bleeding of 2 months' duration. Preoperative investigation diagnosed an infiltrating squamous carcinoma of the cervix. A radical hysterectomy with bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy were performed. Final diagnosis was SCNCC (FIGO stage III B) and therefore adjuvant radiochemotherapy was given. At 1-year follow-up the patient was free of disease.
Despite the retrospective studies and case reports reported, in literature the best modality of treatment remains controversial. Multicenter clinical trials are needed to determine a univocal and effective treatment for SCNCC in order to achieve significant survival benefit.
小细胞神经内分泌宫颈癌(SCNCC)是一种罕见肿瘤,占宫颈肿瘤的1% - 3%。SCNCC兼具宫颈肿瘤的临床和生物学特征(如局部侵袭性和乳头瘤病毒感染)以及任何部位神经内分泌小细胞癌的特征(如疾病早期播散和不同位点杂合性缺失),使其成为一种独特的疾病实体。关于最佳治疗策略尚无一致意见。
一名48岁、孕3产的白人女性,因持续2个月的绝经后出血前来就诊。术前检查诊断为宫颈浸润性鳞状细胞癌。行根治性子宫切除术加双侧输卵管卵巢切除术、盆腔及腹主动脉旁淋巴结清扫术。最终诊断为SCNCC(国际妇产科联盟III B期),因此给予辅助放化疗。1年随访时患者无疾病复发。
尽管文献中有回顾性研究和病例报告,但最佳治疗方式仍存在争议。需要进行多中心临床试验以确定SCNCC明确有效的治疗方法,从而实现显著的生存获益。