Complexities in differential diagnosis of poorly differentiated large cell neuroendocrine carcinoma of the cervix: a case report

Neuroendocrine tumors (NETs) of the female reproductive system, including the cervix, are considered to be extremely rare localizations. the majority (about 80 %) of these cervical NETs are small-cell neuroendocrine carcinomas (SCNECs), which are highly aggressive and have a poor prognosis. Many SCNECs are not recognized leading to a missed diagnosis. Diagnosis relies on identifying neuroendocrine differentiation through immunohistochemical (IHC) examinations, but sometimes this step is omitted. Case presentation. We herein report a case of a low-differentiated large-cell neuroendocrine carcinoma of the cervix in a 40-yearold woman. Verification of the diagnosis was challenging, that required the use of an extended diagnostic complex to identify the optimal management strategy. After surgery the patient received a total of 4 lines of chemotherapy and underwent IHC testings. However, despite all efforts, the patient’s condition worsened significantly, leading to the death 2 years and 1 month after her initial visit. Conclusion. Vague symptoms, aggressive progression, diagnostic difficulty, and limited treatments indicate the need to create specialized centers for the treatment of NETs of any tumor grade and location.