479 Small cell neuroendocrine carcinoma of the cervix: A case report

Introduction/Objective Cervical small cell neuroendocrine carcinoma (SCNEC) is an exceptionally rare and aggressive form of cervical cancer. We present a 37 year old female who sought medical attention after vaginal discharge and abnormal bleeding. Methods/Case Report Physical examination revealed multiple very friable polypoid masses on the cervix at 11:00 position. Her Pap smear came back showing malignant cells consistent with an epithelial neoplasm, highly suspicious for a neuroendocrine carcinoma, and positive for high-risk human papillomavirus (HPV) 18. A follow-up biopsy showed a cervical tumor composed of small to intermediate-sized cells with a very high nuclear/cytoplasmic ratio, round to oval nuclei with molding and finely granular chromatin. Ancillary immunohistochemistry testing revealed tumor cells diffusely positive for synaptophysin and CD56, with a Ki-67 proliferation index >90% and p16 diffuse positivity. The lesion was diagnosed as small cell neuroendocrine carcinoma. Results NA Conclusion Small cell neuroendocrine carcinoma of the cervix accounts for less than 2% of all cervical invasive carcinomas, with an estimated incidence of 0.06 per 100,000 women annually. It predominantly affects younger women, most commonly between the ages of 35 and 50. Risk factors include infection with HPV, particularly HPV-18, as well as multiple sexual partners, smoking, and immunosuppression.