Large-cell neuroendocrine carcinoma arising in the endometrium: A case report

Abstract

Large-cell neuroendocrine carcinoma (LCNEC) of the endometrium is an extremely rare, high-grade malignant tumor. We herein report a case of a rapidly growing LCNEC arising in the endometrium. A 52-year-old woman was referred to Toyooka Hospital (Tooyoka, Japan) due to genital bleeding in February 2016. There had been no abnormalities on a regular gynecological and physical examination 3 months prior to the consultation. Imaging (computed tomography and magnetic resonance imaging) and a pelvic examination revealed a tumor sized 16.9×8.4×7.8 mm occupying the intrauterine cavity and extending into the vaginal cavity. Multiple metastatic pelvic and paraaortic lymph nodes were also identified. Continuous bleeding from the tumor was observed, and a blood examination revealed anemia, which was likely due to that bleeding. Biopsy of the tumor was performed, and large atypical cells were identified. The tumor cells were negative for cytokeratin AE1/AE3 and chromogranin A, but positive for CD56 and synaptophysin. There was also an abundance of Ki-67-positive cells in the tumor, altogether suggesting that the tumor was an LCNEC. The patient succumbed to the disease 36 days after the first consultation. Based on the findings of the present case and previously published cases, LCNECs arising in the endometrium may progress rapidly and are associated with an unfavourable outcome. LCNEC should be included in the differential diagnosis in cases of rapidly growing tumors of the uterine corpus.

Characteristics of MR Imaging for Staging and Survival Analysis of Neuroendocrine Carcinoma of the Endometrium: A Multicenter Study in Japan

“…The average age of 42 patients with endometrial SCNEC at the time of diagnosis was reported to be 60 years old, 3 while Ogura et al 11 noted ages ranging from 40 to 88 years (mean 62 years) for 19 cases of endometrial LCNEC. In a series of 25 patients with endometrial NEC (LCNEC 15, SCNEC 4, mixture of both 6), patient age ranged from 37 to 87 years (median 57 years).…”

“…If MRI can be shown to correctly diagnose endometrial NEC and provide accurate staging prior to treatment, it would be utilized as a helpful clinical tool. To the best of our knowledge, only four case reports discussing the MRI characteristics of endometrial LCNEC have been presented, [8][9][10][11] while none are known to include discussion of MRI findings of endometrial SCNEC, thus the MRI features of endometrial NEC are not well understood. The aim of this study was to identify distinct features as well as staging accuracy of endometrial NEC shown by MRI, including SCNEC and LCNEC.…”

Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan

“…The majority of neuroendocrine tumors of the endometrium are SCNEC; they account for approximately <1% of all endometrial carcinomas. LCNEC of the endometrium is considered rarer than SCNEC [4567]. To date, there have only been 2 reports of carcinoid tumors of the uterine corpus [89].…”

Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

“…Large cell neuroendocrine carcinoma (LCNEC) is a high-grade neoplasm most commonly presenting in the lung, although it has been noted in the literature to occasionally arise in other locations including the gastrointestinal tract, bladder, prostate, gallbladder, ovary, uterus and submandibular gland (1)(2)(3)(4)(5)(6)(7). LCNEC is a rare cancer, estimated to comprise between 2.1 and 3.5% of surgically resected lung tumors (8,9).…”