Santos Luís Guilherme, Roque Ricardo, Antunes Santos Rita, Pereira Tatiana, Pazos Isabel
Medical Oncology Department, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, PRT.
Cureus. 2024 Dec 5;16(12):e75144. doi: 10.7759/cureus.75144. eCollection 2024 Dec.
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.
宫颈神经内分泌癌（NECC）是一种罕见且极具侵袭性的疾病。治疗选择有限（主要是铂类化疗联合方案），且缺乏随机对照试验，导致预后极差。它易于早期转移，诊断时通常有不止一个受累部位。肺、肝、脑和骨是最常见的转移部位。我们报告一例33岁女性患者，既往无重大病史。性交后出血经宫颈肿物组织活检后诊断为人乳头瘤病毒（HPV）相关的NECC。疾病分期显示乳房、胰腺和卵巢疑似转移，其中每个部位在文献中都很少被描述。乳房和卵巢转移均通过活检在组织学上得到证实，而胰腺转移根据影像学表现高度可疑转移。该患者开始接受一线化疗，出现明显毒性反应且疾病进展迅速，目前正在接受三线化疗。据我们所知，这是首次报道同时出现这些非常罕见的NECC转移部位的病例，凸显了这个具有挑战性的疾病实体的复杂性。
