Large-cell neuroendocrine carcinoma of the uterine cervix - A clinicopathological study of five cases

Objective. The present study describes 5 cases of large-cell neuroendocrine carcinoma (LCNEC) of the uterine cer ix, evaluating their clinical feature s and pathological profiles. Methods. Clinical data were obtained from the patients' clinical files at the combined gynaecological-oncology unit of Jo hannesburg Hospital and the University of the Witwatersrand Medical School, Johannesburg, South Africa. Methods. Clinical data were obtained from the patients' clinical files at t he combined gynaecological-oncology unit of Johannesburg Hospital and the U niversity of the Witwatersrand Medical School, Johannesburg, South Africa. A histopathological diagnosis was obtained after biopsy material from all 5 patients was examined microscopically and subjected to immunohistochemical staining with MNF116 (pankeratin), synaptophysin and chromagranin A, all o f which are neuroendocrine markers. Two patients received pelvic radiothera py only. None of the 5 patients in this series received chemotherapy or und erwent surgery. Results. All 5 patients were adult females, with an average age of 57.3 yea rs. The majority were multiparous, with the most common presenting complain t being vaginal bleeding. Three of the 5 patients presented with advanced-s tage cervical carcinoma, with evidence of metastases in 2 of them. Treatmen t responses and long-term survival in our series proved to be disappointing as 3 of the 5 patients died in less than 6 months. On histopathological ex amination, all 5 tumours showed features of a high-grade poorly differentia ted malignant neoplasm with ulceration and extensive tumour necrosis includ ing trabecular and organoid growth patterns. All 5 neoplasms also showed st rong immunoreactivity for MNF116, while their endocrine nature was confirme d by staining for synaptophysin in all cases. None of the rumours showed po sitive staining for chromagranin A. Conclusions. LCNECs are rare tumours and distinct from other neoplasms of t he uterine cen ix. The results of this study reaffirm the biologically aggr essive nature of this uncommon tumour and its very unfavourable prognosis.