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Neuroendocrine Carcinoma of the Cervix: Review of a Series of Cases and Correlation With Outcome.

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posted on 2018-04-10, 12:19 authored by Raji Ganesan, Lynn Hirschowitz, Philip Dawson, Sarah Askew, Philippa Pearmain, Peter W. Jones, Kavita Singh, Kiong K. Chan, Esther L. Moss
Introduction Neuroendocrine carcinoma (NEC) of the cervix is associated with a poor prognosis despite multimodal treatment. The correct diagnosis of this tumor type is imperative to provide clinicians and patients with prognostic information and ensure that appropriate treatment is provided. Methods A clinicopathological study was undertaken on all cervical tumors registered as NEC with the West Midlands Cancer Intelligence Unit between January 1, 1998 and December 31, 2009. Of the 45 cases diagnosed during the study period, the tumor samples of 41 cases were traced, anonymized, and then independently reviewed by 2 gynecological pathologists. Results The review confirmed 31/41 (78%) cases to be NEC, which overall, represented 1.3% of all the cervical cancers registered in the West Midlands over the period of the study. In the correct histological context, synaptophysin was the most sensitive and specific positive immunohistochemical marker of NEC differentiation. The cases that on review were confirmed as NEC had a significantly worse outcome than the non-NEC cases: median survival for NEC cases was 33.3 months versus 315.0 months for the non-NEC cases, P = .013. Conclusions Histological review of a series of NECs has shown significantly reduced survival in those patients with confirmed NEC in comparison with those patients where a diagnosis of NEC was not confirmed. We propose morphological and immunohistochemical criteria for the diagnosis of cervical NEC; and discourage unqualified use of the term "small cell carcinoma" as this does not accurately convey the diagnosis of SCNEC. We urge pathologists to use the 2014 World Health Organization classification when reporting these tumors.

Funding

Funding for this study was provided by the British Society of Colposcopy and Cervical Pathology (BSCCP).

History

Citation

International Journal of Surgical Pathology, 2016, 24 (6), pp. 490-496

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cancer Studies and Molecular Medicine

Published in

International Journal of Surgical Pathology

Publisher

SAGE Publications (UK and US)

issn

1066-8969

eissn

1940-2465

Copyright date

2016

Available date

2018-04-10

Publisher version

http://journals.sagepub.com/doi/10.1177/1066896916643385

Language

en

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