Clinical case of combined malignant neoplasm of the cervix: neuroendocrine carcinoma and squamous cell cancer
https://doi.org/10.20340/vmi-rvz.2025.3.MORPH.2
Abstract
Neuroendocrine carcinomas are rare and aggressive types of cervical tumors. Available literature contains limited descriptions of mixed carcinomas, and knowledge about this type of mixed carcinoma remains limited. Morphological diagnosis of this carcinoma type can be difficult due to the fact that neuroendocrine carcinoma cells can resemble squamous cell carcinoma. Additional complications can be caused by the lack of expression of some specific neuroendocrine markers. Incorrect diagnosis of this carcinoma can lead to incorrect patient management tactics or treatment delays. This article presents a clinical observation of a 45-year-old female patient who was diagnosed with mixed neuroendocrine and squamous cell carcinoma of the cervix, HPV-associated, with multiple metastases. This case is of particular interest due to the rarity of this pathology and diagnostics challenges it presents.
Keywords
About the Authors
T. A. GarkushaRussian Federation
Tat'yana A. Garkusha - Assistant of the Department of Pathological Anatomy named after Professor P.G. Podzolkov; pathologist
Author's contribution: author of the idea, writing the working version of the manuscript, responsibility for the integrity of all parts of the article, preparation of illustrations.
1, Partizana Zheleznyaka str., Krasnoyarsk, 660022;
3D, Partizana Zheleznyaka str., Krasnoyarsk, 660022
Competing Interests:
The authors declare no competing interests.
A. N. Zagrebel'nikova
Russian Federation
Aleksandra N. Zagrebel'nikova - Student of the Pediatrics Department
Author's contribution: writing the working version of the manuscript, responsibility for the integrity of all parts of the article.
1, Partizana Zheleznyaka str., Krasnoyarsk, 660022
Competing Interests:
The authors declare no competing interests.
V. N. Shelepova
Russian Federation
Viktoriya N. Shelepova - Student of the Faculty of Pediatrics
Author's contribution: writing the working version of the manuscript, responsibility for the integrity of all parts of the article.
1, Partizana Zheleznyaka str., Krasnoyarsk, 660022
Competing Interests:
The authors declare no competing interests.
F. V. Alyab'ev
Russian Federation
Fedor V. Alyab'yev - Dr. Cand. Sci. (Med.), Professor, Head of the Department of Pathological Anatomy named after Professor P.G. Podzolkov, Head of the Department of Forensic Medicine and PO
Author's contribution: scientific consultant, editing the text of the article.
1, Partizana Zheleznyaka str., Krasnoyarsk, 660022
Competing Interests:
The authors declare no competing interests.
N. V. Khludneva
Russian Federation
Natal'ya V. Khludneva - Cand. Sci. (Med.), Docent, department of forensic medicine and PO
Author's contribution: scientific consultant, editing the text of the article.
1, Partizana Zheleznyaka str., Krasnoyarsk, 660022
Competing Interests:
The authors declare no competing interests.
References
1. TempferCB, TischoffI, DoganA, HilalZ, SchultheisB, KernP et al. Neuroendocrine carcinoma of the cervix: a systematic review of the literature. BMC Cancer. 2018 May 4;18(1):530. https://doi.org/10.1186/s12885-018-4447-x. PMID: 29728073
2. Winer I, Kim C, Gehrig P. Neuroendocrine tumors of the gynecologic tract update.Gynecol Oncol. 2021;Jul;162(1):210-219. https://doi.org/10.1016/j.ygyno. 2021.04.039. PMID: 34023130
3. Le DT, Do KH, Do TA, Bui HTT, Nguyen CV. Combined Large-Cell Neuroendocrine and Squamous Cell Carcinoma of the Uterine Cervix with a Personal History of the Primary Breast Duct Carcinoma in situ: A Clinicopathological Characteristic and Outcome. Case Rep Oncol. 2022 Aug 30;15(2):770-775. https://doi.org/10.1159/000526337. PMID: 36157693
4. Kaushal S, Mathur SR, Kumar S. Coexisting squamous cell carcinoma and high-grade neuroendocrine carcinoma, small cell type: a rare collision in cervix. BMJ Case Rep. 2018 May 18;2018:bcr2017223127. https://doi.org/10.1136/bcr-2017-223127. PMID: 29778998
5. Oronsky B, Ma PC, Morgensztern D, Carter CA. Nothing But NET: A Review of Neuroendocrine Tumors and Carcinomas. Neoplasia. 2017 Dec;19(12):991-1002. https://doi.org/10.1016/j.neo.2017.09.002. PMID: 29091800
6. Guadagno E, De Rosa G, Del Basso De Caro M. Neuroendocrine tumours in rare sites: differences in nomenclature and diagnostics—a rare and ubiquitous histotype. J Clin Pathol. 2016 Jul;69(7):563-74. https://doi.org/10.1136/jclinpath-2015-203551. PMID: 26915369
7. Caruso G, Sassu CM, Tomao F, Di Donato V, Perniola G, Fischetti M et al. The puzzle of gynecologic neuroendocrine carcinomas: State of the art and future directions. Crit Rev Oncol Hematol. 2021 Jun;162:103344. https://doi.org/10.1016/j.critrevonc.2021.103344. PMID: 33933568.
8. Wang G, Chen P, Shi L, Zhao W. Squamous cell carcinoma arising from an unknown primary site metastasizing to the stomach: A case report. Oncol Lett. 2014 Apr;7(4):1063-1066. https://doi.org/10.3892/ol.2014.1836. PMID: 24944669
9. He F, He X, Cui M et al. Mixed small cell neuroendocrine carcinoma and squamous cell carcinoma covered by tubulovillous adenoma in the rectum: a case report and detailed molecular analyses. World J Surg Onc. 2023 Feb 27;21(1):65. https://doi.org/10.1186/s12957-023-02954-6. PMID: 36849965
10. Verma S, Dubey H, Gupta S, Ranjan A, Goel H, Sharma A. Neuroendocrine carcinoma of cervix and review literature. Int J Surg Case Rep. 2023 Apr;105:107982. https://doi.org/10.1016/j.ijscr.2023.107982. PMID: 36948055
11. Vallejo-Ruiz V, Gutiérrez-Xicotencatl L, Medina-Contreras O, Lizano M. Molecular aspects of cervical cancer: a pathogenesis update. Front Oncol. 2024 Mar 19;14:1356581. https://doi.org/10.3389/fonc.2024.1356581. PMID:38567159
12. Ye J, Zheng L, He Y, Qi X. Human papillomavirus associated cervical lesion: pathogenesis and therapeutic interventions. MedComm (2020). 2023 Sep 14;4(5):e368. https://doi.org/10.1002/mco2.368. PMID: 37719443
13. Castle PE, Pierz A, Stoler MH. A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix. Gynecol Oncol. 2018 Feb;148(2):422-429. https://doi.org/10.1016/j.ygyno.2017.12.001. PMID: 29248196.
14. Wei KN, Fu XD, Wang MY, Wang LX. Two cases of mixed large cell neuroendocrine carcinoma and adenocarcinoma of the cervix: case report and review of the literature. Diagn Pathol. 2024 Dec 26;19(1):166. https://doi.org/10.1186/s13000-024-01592-0. PMID: 39726011; PMCID: PMC11670507.
15. Gurubalan G, Parwaiz A, Ajit S, Kumar T, Kumari M, Bhadani P. Small cell neuroendocrine carcinoma with adenocarcinoma and high grade squamous intraepithelial neoplasia of the cervix. Autops Case Rep. 2023 Nov 13;13:e2023452. PMID: 38034519; PMCID: https://doi.org/10.4322/acr.2023.452. PMC10688200
16. An J, Hu X, He X, Wang J, Mueller MD et al. Cervical cancer in pregnancy: one case report and a review of current treatment recommendations. Gynecol Pelvic Med 2019;2:10. https://doi.org/10.21037/gpm.2019.07.01.
17. Shimojo N, Hirokawa YS, Kanayama K, Yoneda M, Hashizume R, Hayashi A et al. Cytological features of adenocarcinoma admixed with small cell neuroendocrine carcinoma of the uterine cervix. Cytojournal. 2017 May 26;14:12. https://doi.org/10.4103/1742-6413.207139. PMID: 28603541
18. Toki T, Katayama Y, Motoyama T. Small-cell neuroendocrine carcinoma of the uterine cervix associated with micro-invasive squamous cell carcinoma and adenocarcinoma in situ. Pathol Int. 1996 Jul;46(7):520-5. https://doi.org/10.1111/j.1440-1827.1996.tb03648.x. PMID: 8870009.
19. Safronova KV, Artemieva AS, Nuganen AO, Kutusheva GF, Chuglova DA, Mikaya NA et al. NEUROENDOCRINE TUMORS OF THE CERVIX. Siberianjournalofoncology. 2020;19(5):97-107. https://doi.org/10.21294/1814-4861-2020-19-5-97-107.
20. Lamiman K, Wilhelm AB, Eyzaguirre E, Richardson G. Diagnostic Challenges and Long-term Outcomes of Neuroendocrine Carcinoma of the Cervix: A Case Series. Int J Gynecol Pathol. 2024 Mar 1;43(2):149-157. https://doi.org/10.1097/PGP.0000000000000983. PMID: 37922936
Supplementary files
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For citations:
Garkusha T.A., Zagrebel'nikova A.N., Shelepova V.N., Alyab'ev F.V., Khludneva N.V. Clinical case of combined malignant neoplasm of the cervix: neuroendocrine carcinoma and squamous cell cancer. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2025;15(3):151-155. (In Russ.) https://doi.org/10.20340/vmi-rvz.2025.3.MORPH.2