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子宫内膜混合性大细胞和小细胞神经内分泌癌伴浆液性癌:一例报告及文献复习

Mixed large and small cell neuroendocrine carcinoma of the endometrium with serous carcinoma: A case report and literature review.

作者信息

Hu Ruijiao, Jiang Jiyong, Song Guangyao, Zhu Chenggong, Chen Liyan, Wang Chenhui, Wang Xiuying

机构信息

Department of Gynecology.

Department of Pathology, Dalian Gynecology and Obstetrics Hospital Affiliated to Dalian Medical University, Liaoning, Dalian, China.

出版信息

Medicine (Baltimore). 2019 Jul;98(29):e16433. doi: 10.1097/MD.0000000000016433.

Abstract

RATIONALE

Endometrial neuroendocrine carcinoma is a rare histological subtype of endometrial cancer, divided into low-grade neuroendocrine carcinoma (carcinoid) and high-grade neuroendocrine carcinoma (small cell and large cell neuroendocrine carcinoma). It is characterized by high invasiveness and poor prognosis. L/SCNEC is an extremely rare pathological type of endometrial carcinoma, and the number of reports on this condition is few globally.

PATIENT CONCERNS

A 54-year-old Chinese female presented with vaginal bleeding.

DIAGNOSES

Outpatient hysteroscopy and endometrial biopsy were performed, and the pathological examination revealed that cervix was invaded by endometrial malignancy. The patient underwent a laparoscopic radical hysterectomy was diagnosed with the mixed large and small cell neuroendocrine carcinoma (L/SCNEC) of the endometrium combined with serous carcinoma III C2 (FIGO2009).

INTERVENTIONS

Chemotherapy-radiotherapy-chemotherapy "sandwich" treatment was performed as postoperative therapy.

OUTCOMES

After three chemotherapy circles, the patient showed no evidence of further disease progression.

LESSONS

L/SCNEC is a rare and invasive disease. Once diagnosed, comprehensive treatments including surgery, radiotherapy, and chemotherapy can prolong the survival of patients and improve the prognosis.

摘要

理论依据

子宫内膜神经内分泌癌是子宫内膜癌中一种罕见的组织学亚型,分为低级别神经内分泌癌(类癌)和高级别神经内分泌癌(小细胞和大细胞神经内分泌癌)。其特点是侵袭性高且预后差。大/小细胞神经内分泌癌是子宫内膜癌一种极其罕见的病理类型,全球范围内关于这种情况的报道很少。

患者情况

一名54岁中国女性因阴道出血就诊。

诊断

门诊进行了宫腔镜检查和子宫内膜活检,病理检查显示宫颈被子宫内膜恶性肿瘤侵犯。患者接受了腹腔镜根治性子宫切除术,被诊断为子宫内膜大/小细胞神经内分泌癌合并浆液性癌ⅢC2(国际妇产科联盟2009年分期)。

干预措施

术后采用化疗-放疗-化疗“三明治”治疗。

结果

经过三个化疗周期后,患者未出现疾病进一步进展的迹象。

经验教训

大/小细胞神经内分泌癌是一种罕见且具有侵袭性的疾病。一旦确诊,包括手术、放疗和化疗在内的综合治疗可以延长患者生存期并改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e913/6709041/f4944919fd23/medi-98-e16433-g002.jpg

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