Ntalakos Nektarios, Arnaouti Maria, Arkoumani Evdokia
Department of Pathology, Saint Savvas Anticancer Hospital of Athens, Athens, GRC.
Cureus. 2025 Aug 5;17(8):e89439. doi: 10.7759/cureus.89439. eCollection 2025 Aug.
Small cell neuroendocrine carcinoma of the cervix is an uncommon, aggressive tumor that most often affects women in their 40s and is frequently linked to high-risk human papillomavirus (HPV) infection. It is associated with poor prognosis even in early-stage disease. We report the case of a 36-year-old woman with high-risk HPV who presented with abnormal vaginal bleeding. Colposcopy, followed by biopsy and positron-emission tomography computed tomography, confirmed International Federation of Gynecology and Obstetrics stage IIB small cell neuroendocrine cervical carcinoma. The patient underwent external beam radiotherapy and brachytherapy, followed by cisplatin and etoposide chemotherapy. A significant reduction in tumor size was achieved, and interval surgery confirmed residual neuroendocrine carcinoma with extensive vascular invasion. Its diagnosis requires careful histopathologic and immunohistochemical evaluation to differentiate it from morphologic mimics and to exclude metastatic disease. Due to its rarity, there are no standardized treatment protocols, with current approaches favoring individualized, multidisciplinary management. Chemoradiation remains the cornerstone of therapy in locally advanced disease. The potential utility of immunotherapy and targeted agents is currently under investigation. Small cell neuroendocrine carcinoma of the uterine cervix remains a challenging malignancy to diagnose and treat, with early recognition and coordinated multimodal care able to improve outcomes.
宫颈小细胞神经内分泌癌是一种罕见的侵袭性肿瘤，多见于40多岁的女性，常与高危型人乳头瘤病毒（HPV）感染有关。即使在疾病早期，其预后也较差。我们报告了一例36岁高危HPV感染的女性患者，该患者出现阴道异常出血。经阴道镜检查，随后进行活检及正电子发射断层扫描计算机断层扫描，确诊为国际妇产科联盟IIB期宫颈小细胞神经内分泌癌。患者接受了外照射放疗和近距离放疗，随后进行顺铂和依托泊苷化疗。肿瘤大小显著缩小，间隔手术证实残留神经内分泌癌伴广泛血管侵犯。其诊断需要仔细的组织病理学和免疫组化评估，以将其与形态学上的相似病变相鉴别，并排除转移性疾病。由于其罕见性，目前尚无标准化的治疗方案，当前的治疗方法倾向于个体化的多学科管理。放化疗仍然是局部晚期疾病治疗的基石。免疫疗法和靶向药物的潜在效用目前正在研究中。宫颈小细胞神经内分泌癌仍然是一种诊断和治疗都具有挑战性的恶性肿瘤，早期识别和协调的多模式治疗能够改善治疗效果。
