Tsou M H, Tan T D, Cheng S H, Chiou Y K
Department of Pathology and Laboratory Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan, Republic of China.
Gynecol Oncol. 1998 Jan;68(1):69-72. doi: 10.1006/gyno.1997.4899.
A case of cervical small cell carcinoma (SCC) with large cell neuroendocrine carcinoma (LCNC) differentiation is presented. A 35-year-old Taiwanese woman was diagnosed as having stage IIB bulky SCC confirmed by cervical biopsy and underwent induction combination chemoradiotherapy followed by hysterectomy. The pathology of the cervical tumor after the initial treatment showed the residual tumor to be LCNC instead of SCC. Histochemistry, immunohistochemistry, and electron microscopy demonstrated presence of neuroendocrine differentiation on both the biopsy and the surgical specimens. Following surgical resection a course of adjuvant chemotherapy and a local radiation boost were added. Despite complete local control, she developed brain metastasis 8 months later and vertebral spread soon thereafter. The pathology of the brain tumor showed pure SCC. The patient died 19 months after diagnosis and 13 months after completion of treatment. This case suggests that SCC with LCNC component has a similar clinical course as a pure SCC.
本文报告一例具有大细胞神经内分泌癌（LCNC）分化的宫颈小细胞癌（SCC）病例。一名35岁的台湾女性经宫颈活检确诊为IIB期巨大SCC，接受诱导联合放化疗，随后行子宫切除术。初始治疗后宫颈肿瘤的病理显示残留肿瘤为LCNC而非SCC。组织化学、免疫组织化学和电子显微镜检查表明活检标本和手术标本均存在神经内分泌分化。手术切除后增加了辅助化疗疗程和局部放疗加强治疗。尽管实现了完全局部控制，但她在8个月后发生脑转移，随后不久出现椎体转移。脑肿瘤的病理显示为纯SCC。患者在诊断后19个月和治疗完成后13个月死亡。该病例提示具有LCNC成分的SCC与纯SCC具有相似的临床病程。
