Clinicopathological analysis of nine cases of small cell carcinoma of the uterine cervix

Abstract

To investigate the clinicopathologic characteristics, therapy and prognostic factors of small cell carcinoma of the uterine cervix (SCCC). Nine patients with SCCC underwent radical hysterectomy at the Cancer Hospital of CAMS between 2000 to 2009. Clinical and pathological data were analyzed, and the related literature was reviewed. The average age of 9 patients was 41 years old. Irregular vaginal bleeding and postcoital spotting were the most common symptoms. According to FIGO staging criteria, six patients were stage Ib1 disease, 2 stage Ib2 and 1 stage IVb. All tumors were composed of small-sized cells with scant cytoplasm, darkly stained round to oval nuclei, finely dispersed chromatin and absence of nucleoli. High mitotic activity and lymphovascular invasion were also common findings. Immunohistochemical staining showed at least three neuroendocrine markers (NSE, CgA, Syn and CD56) were positive in each case. All patients received postoperative chemotherapy, with or without radiotherapy. Seven patients remained alive 6 to 104 months and one died 14 months postoperatively. SCCC is a highly malignant tumor with aggressive behavior. Correct diagnosis of SCCC depends on the combination of light microscopic and immunohistochemical analysis. It is necessary to use multimodality treatment for SCCC, especially the chemotherapy. However, the prognosis is dismal.