Carcinoid syndrome caused by an atypical carcinoid of the uterine cervix

Neuroendocrine tumors of the cenix are rare and are often under- or misdiag nosed. Because these tumors are very aggressive, early diagnosis and subseq uent treatment are warranted. We describe a 46-yr-old woman with carcinoid syndrome caused by an atypical carcinoid of the uterine cervix. At age 44, she had dysplasia on Pap smear and underwent total abdominal hysterectomy w ith the diagnosis of adenocarcinoma. Fourteen months postoperatively, she d eveloped the carcinoid syndrome and was found to have numerous liver metast ases. Histological and immunohistochemical investigations of biopsy specime ns from the patient's liver lesions and original cervical lesion ("adenocar cinoma") suggested that this woman had a primary atypical carcinoid of the uterine cervix with metastases to the liver. Treatment with octreotide and alkylating agents decreased the episodes of flushing and diarrhea within 8 weeks. If an adenocarcinoma of the uterine cervix is diagnosed, atypical ca rcinoid should be in the differential diagnosis. Symptoms of the carcinoid syndrome should be pursued and, if present, a urinary 5-hydroxyindolacetic acid level should be obtained. Timely diagnosis of a neuroendocrine tumor o f the cervix may improve survival.