Cervical neuroendocrine carcinoma: a clinical and light microscopic study of 14 cases

Fourteen primary cervical neoplasms with light microscopic features of neuroendocrine carcinoma were studied. Two were of intermediate cell type (IC), resembling the pulmonary atypical carcinoid; seven were small cell type (SC), analogous to pulmonary oat cell carcinoma; two were SC with foci of IC; three were SC with foci of squamous or adenocarcinoma. Four patients were Stage I, five were Stage II, two were Stage III, and three were Stage IV. One patient (Stage I) underwent hysterectomy and has completed radiation therapy. Two patients underwent radical hysterectomy and chemotherapy. One received radiation and chemotherapy; one received only chemotherapy; nine received radical radiation therapy. One patient (Stage I) is alive and well 10.5 years later; one (Stage II) died of other causes 24 months after diagnosis. One other is alive with the disease 12 months postdiagnosis. Eleven died secondary to tumor, four to 33 months (mean 14, median 12.5 months) after diagnosis. There was no significant difference in survival between IC and SC types, either mixed or pure. Cervical neuroendocrine carcinomas are biologically aggressive neoplasms, regardless of histologic type.