128 A Case of Small Cell Neuroendocrine Carcinoma Coexisting With Adenocarcinoma of the Uterine Cervix. (11th January 2018)

• Record Type: Journal Article
• Authors: Zhang, Yingtao; Huang, Ying; Amatya, Sirisa Kandel
• Is Part Of: American journal of clinical pathology. Volume 149(2018)Supplement 1
• Page Start: S56
• Page End: S56
• Publication Date: 2018-01-11
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqx119.127
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Small cell neuroendocrine carcinoma of the cervix is a rare disease, accounting for 1% of all invasive cervical carcinoma. Here we report such a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma. The patient is a 49-year-old multiparous and postmenopausal woman who presented with abnormal uterine bleeding. Endometrial biopsy revealed high-grade neuroendocrine carcinoma, small cell type with rare atypical endometrial glands. However, since no adequate endometrial glands are present for evaluation, high-grade adenocarcinoma with neuroendocrine features is also in the differential diagnosis. Subsequent radical hysterectomy with bilateral salpingo-oophorectomy specimen revealed a 3 cm exophytic and hemorrhagic mass in the endocervical canal. Neoplastic cells are predominantly composed of sheets of pleomorphic cells with scant cytoplasm, pleomorphic nuclei and inconspicuous nucleoli. Nuclear molding, apoptotic bodies, and abundant mitotic figures (>10 mitoses/HPF) are also noted. Well differentiated invasive endocervical adenocarcinoma is noted adjacent to and admixed with sheets of pleomorphic neoplastic cells. The sheets of neoplastic cells are positive for CD56, synaptophysin, p16, and p53, and negative for pancytokeratin, CK7, and CK903, which is consistent with small cell neuroendocrine carcinoma. The glandular component is positive for p16, pancytokeratin, CK7, CK903, and p53 (focal), and negative for vimentin, CD56, and synaptophysin. Both components are negative for ER, PR, and chromogranin. The morphology and immunoprofile favor composite small cell neuroendocrine carcinoma and adenocarcinoma of the uterine cervix. The final pathologic staging is pT2b N1 Mx with left parametrium involvement and positive lymph nodes. The patient underwent chemotherapy and is closely followed up showing normal CA125 and unremarkable abdominal/pelvic CT scan.