Imaging of Gynecologic Neuroendocrine Tumors: A Case-Based Pictorial Essay

Gynecologic neuroendocrine tumors (NETs) are rare, highly aggressive malignancies that can arise in any part of the female reproductive tract, most often in the cervix. Their clinical course is marked by rapid progression, early spread, and limited treatment options, making prompt recognition essential. Diagnosis depends on histopathologic evaluation, supported by immunohistochemistry, while imaging (particularly magnetic resonance) plays a central role in staging, treatment planning, and follow-up, despite often nonspecific appearances. This narrative pictorial review integrates current understanding of histopathologic classification, clinical presentation, and imaging characteristics across modalities, highlighting features that may raise suspicion for these tumors and common diagnostic pitfalls. Representative cases illustrate the spectrum of disease, from localized lesions to widely metastatic presentations. Management typically involves multimodal strategies, with growing interest in targeted and immune-based therapies. By combining clinical, pathologic, and radiologic perspectives, this review aims to enhance awareness and support more timely, accurate diagnosis of these challenging neoplasms.