Habeeb Amir, Habeeb Hany
Department of Obstetrics and Gynaecology, University College London, London, UK.
Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, UK.
BMJ Case Rep. 2019 Jan 14;12(1):bcr-2018-225880. doi: 10.1136/bcr-2018-225880.
We report a case of large cell neuroendocrine carcinoma of the uterine cervix. A 33-year-old woman presented with a 4-month history of irregular vaginal bleeding and suspicious cervix. Transvaginal ultrasound showed a 3×3.8 cm cervical mass with a marked increase in the blood flow. MRI pelvis showed an exophytic tumour with left external iliac lymph node metastasis. Immunohistochemistry of the tumour cells showed strong positivity for the neuroendocrine markers synaptophysin and a very high Ki67 proliferation index. A diagnosis of high-grade large cell neuroendocrine carcinoma of the uterine cervix was made with FIGO stage IIA2. She was treated with chemotherapy and palliative radiotherapy but died 21 months after presenting. Neuroendocrine tumour of the uterine cervix is an extremely aggressive cancer with the late presentation-the need for a more rigorous treatment protocol as well as potential screening methods could improve outcomes for these patients.
我们报告一例子宫颈大细胞神经内分泌癌病例。一名33岁女性，有4个月不规则阴道出血病史，宫颈可疑病变。经阴道超声显示宫颈有一个3×3.8 cm的肿块，血流明显增加。盆腔MRI显示有一个外生性肿瘤，伴有左髂外淋巴结转移。肿瘤细胞免疫组化显示神经内分泌标志物突触素呈强阳性，Ki67增殖指数非常高。诊断为子宫颈高级别大细胞神经内分泌癌，国际妇产科联盟（FIGO）分期为IIA2期。她接受了化疗和姑息性放疗，但在就诊后21个月死亡。子宫颈神经内分泌肿瘤是一种极具侵袭性的癌症，就诊时已属晚期，因此需要更严格的治疗方案以及潜在的筛查方法，以改善这些患者的治疗结果。
