Dados do Trabalho

Título

NEUROENDOCRINE CARCINOMA OF SMALL CELLS OF THE UTERUS: A CASE REPORT OF A RARE TUMOR

Apresentação do caso

VSP, female, 34 years old, married, was admitted to the service in July 2020, with severe metrorrhagia, pain in the lower abdomen and anemic manifestations, in the last 3 months with the need for transfusion of blood components. Pelvic MRI on 07/03/ /2020 with a voluminous expansive lesion in the uterine cervix, extending inferiorly and occupying the vaginal cavity in its middle and upper thirds, atypical lymph node enlargement in the iliac chains bilaterally (right: 2.2 x 1.9cm and left: 2.2 x 2, 0cm). Histopathology (HP) of small cell neuroendocrine carcinoma (KI 67=80%). A therapeutic proposal of chemotherapy for advanced disease was made, defined as a disease not limited to a radiotherapy field, with an EP scheme which consists of cisplatin, 60 mg/m² EV, on D1 and etoposide, 120 mg/m² EV, from D1 to D3, repeated every 3 weeks, for 6 cycles between 08/03/2020 and 11/16/2020, without noteworthy intercurrences and with cessation of all previously reported gynecological symptoms. In the post-chemotherapy armed scan, there was a complete imaging response. The patient was referred for cancer surgery on 03/22/2021, with HP with no neoplasm (PRC). In April 2021, a new radiological screening was performed without disease. Patient remains in specialized follow-up, asymptomatic.

Discussão

Small carcinomas are defined by the WHO as neuroendocrine tumors. They are rare, comprising between 2.5% and 5.0% in extrapulmonary sites (NASU et al., 2011). When it comes to an involvement in small cells of the uterine cervix, the incidence is even lower, ranging from 0.3% to 3.0% (KIM et al., 2013), it usually has a highly aggressive course and OS in 5 years is 36% and the median OS varies between 22 and 25 months. The two-stage classifications, localized disease and advanced disease, defined as limited or not to a radiotherapy field, respectively, are the most used for the therapeutic definition.The prognosis of cervical CPC is similar to the pulmonary site, in which hematogenous and lymphatic dissemination are early.The preferred treatment is the multimodal, with association of surgery, chemoradiation and systemic chemotherapy (SALVO et al., 2019).

Comentários finais

Small cell carcinoma of the cervix is a rare and aggressive type of neuroendocrine tumor. Due to the rarity of this malignancy and the few cases in the literature, its management is difficult and uncertain, moreover, the need for an interdisciplinary approach for early diagnosis in order to improve the prognosis is essential.

Palavras-chave

Neuroendocrin tumor; cervix; chemotherapy