Small Cell Neuroendocrine Carcinoma of the Uterine Cervix: A Case Report Highlighting a Rare and Aggressive Tumor

Small cell neuroendocrine carcinoma of the cervix is an uncommon, aggressive tumor that most often affects women in their 40s and is frequently linked to high-risk human papillomavirus (HPV) infection. It is associated with poor prognosis even in early-stage disease. We report the case of a 36-year-old woman with high-risk HPV who presented with abnormal vaginal bleeding. Colposcopy, followed by biopsy and positron-emission tomography computed tomography, confirmed International Federation of Gynecology and Obstetrics stage IIB small cell neuroendocrine cervical carcinoma. The patient underwent external beam radiotherapy and brachytherapy, followed by cisplatin and etoposide chemotherapy. A significant reduction in tumor size was achieved, and interval surgery confirmed residual neuroendocrine carcinoma with extensive vascular invasion. Its diagnosis requires careful histopathologic and immunohistochemical evaluation to differentiate it from morphologic mimics and to exclude metastatic disease. Due to its rarity, there are no standardized treatment protocols, with current approaches favoring individualized, multidisciplinary management. Chemoradiation remains the cornerstone of therapy in locally advanced disease. The potential utility of immunotherapy and targeted agents is currently under investigation. Small cell neuroendocrine carcinoma of the uterine cervix remains a challenging malignancy to diagnose and treat, with early recognition and coordinated multimodal care able to improve outcomes.