Rare Becomes Rarer: Neuroendocrine Carcinoma of the Cervix With Synchronous Breast, Pancreatic, and Ovarian Metastases.

Neuroendocrine carcinoma of the cervix (NECC) is a rare and extremely aggressive disease. Treatment options are scarce (mainly consisting of platinum-based chemotherapy combinations), and randomized controlled trials are lacking, leading to a very poor prognosis. It is prone to early metastasis, often with more than one affected site at diagnosis. The lung, liver, brain, and bone are the most frequent sites. We present the case of a 33-year-old female patient with no significant medical history. Postcoital bleeding led to the diagnosis of human papillomavirus (HPV)-related NECC after a tissue biopsy of a cervical mass. Disease staging showed suspected metastasis on the breast, pancreas, and ovaries, each of which is very rarely described in the literature. Both the breast and ovarian metastases were histologically confirmed through biopsy, while pancreatic metastases were deemed highly likely based on radiological findings. The patient was started on first-line chemotherapy with significant toxicities and rapid disease progression and is currently on third-line chemotherapy treatment. To our knowledge, this is the first reported case of these very rare sites of metastasis from NECC being present simultaneously, highlighting the complexity of this challenging entity.