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Small Cell Carcinoma of the Cervix: A Retrospective Clinicopathologic Analysis Over a Period of 3 Years in a Referral Laboratory in India

  • Ekta JainEmail author
  • Shivani Sharma
  • Lata Kini
  • Aditi Dewan
  • Hari Prasad Dhakal
Original Article
  • 11 Downloads

Abstract

Background

Small cell neuroendocrine carcinoma of the cervix is rare, constituting less than 2% of all invasive cervical malignancies. It has a poor prognosis due to aggressive clinical course with high propensity for nodal and distant metastasis leading to mortality. Although it is known to be a chemosensitive tumor, till date no definite treatment modality has been entirely successful.

Methods

Six cases diagnosed as small cell carcinoma of cervix over a period of 3 years were included in the study. Formalin-fixed paraffin-embedded tissue was subjected to hematoxylin and eosin (H&E) staining and microscopic examination. This was followed by a panel of immunohistochemical markers including synaptophysin, chromogranin, non-specific enolase (NSE), cytokeratin (CK), CD56 and Ki67 essential for diagnosis. The clinical and morphological profile in all the cases was then evaluated.

Results

Out of total 265 cervical malignancies reported, six cases (2.3%) were diagnosed as small cell carcinoma. The median age at the time of diagnosis was 49 years (range 28–67 years). All patients presented with irregular vaginal bleeding, with or without lower abdominal pain. Radiological scans revealed a mass in the cervix. Histopathological examination revealed a tumor arranged in diffuse sheets exhibiting high N/C ratio and stippled chromatin. Immunohistochemical markers employed were positive for CK, synaptophysin, chromogranin and NSE and negative for p40, CK5/6 and CD45 in all the cases.

Conclusion

Small cell carcinoma of cervix is a rare malignancy. Because of the high rates of nodal involvement even with early-stage disease, multimodality treatment with radiotherapy and chemotherapy should be considered.

Keywords

Cervix Metastasis Neuroendocrine Small cell carcinoma 

Notes

Authors’ Contribution

EJ was involved in conception, acquisition of data, literature research, manuscript preparation, editing and final approval. SS was involved in conception, data collection, revising the article and final approval. LK was involved in manuscript editing, review and final approval. AD was involved in manuscript preparation and final approval. HPD was involved in conception, editing and final approval.

Funding

None.

Compliance with ethical standards

Conflict of interest

They authors declare that they have no conflict of interest.

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Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Ekta Jain
    • 1
    Email author
  • Shivani Sharma
    • 1
  • Lata Kini
    • 1
  • Aditi Dewan
    • 1
  • Hari Prasad Dhakal
    • 2
  1. 1.Department of PathologyCore DiagnosticsGurgaonIndia
  2. 2.Department of Pathology and Laboratory MedicineNepal Cancer Hospital and Research CenterHarisiddhi, Lalitpur-30, KathmanduNepal

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