Neuroendocrine carcinoma of the endometrium: A very rare gynecologic malignancy - 26/08/20

Doi : 10.1016/j.jogoh.2020.101897

Utku Akgor ^a,⁎ , Oguzhan Kuru ^b, Mehmet Sakinci ^c, Gokhan Boyraz ^d, Serhat Sen ^e, Ilker Cakır ^b, Taner Turan ^d, Mehmet Gokcu ^b, Murat Gultekin ^a, Sevil Sayhan ^f, Coskun Salman ^a, Nejat Ozgul ^a
^a Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
^b Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
^c Department of Obstetrics and Gynecology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
^d Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
^e Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Izmir Katip Celebi University, Izmir, Turkey
^f Department of Pathology, Tepecik Education and Research Hospital, Izmir, Turkey

^⁎Corresponding author at: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, 06230, Turkey.Department of Obstetrics and GynecologyDivision of Gynecologic OncologyFaculty of MedicineHacettepe UniversityAnkara06230Turkey

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Abstract

Objective

To investigate the clinicopathologic characteristics, prognostic factors, outcome, and treatment of the neuroendocrine carcinoma (NEC) of the endometrium.

Materials and methods

We retrospectively reviewed the clinicopathologic and survival data of 10 patients who underwent surgery for NEC. The patients were collected between 1999 and 2017 from four referral centers in Turkey.

Results

The median age of patients was 67 years (range: 34–75 years). The NEC of endometrium consist of 9 cases with small cell carcinoma (SC) NEC (two with mixed histotypes), and one with a large cell (LC) NEC. According to FIGO 2009 criteria, 70 % (7/10) of patients had advanced stage (III and IV) disease. All patients except one underwent surgical staging, eight patients received platinum-based chemotherapy (CTX) and of 6 those were additionally treated with radiotherapy (RT). Four patients died of disease ranging from 2 to 10 months and six were alive 12–72 months with no evidence of disease. In addition, 4 SC NEC cases raised in polypoid features had no evidence of disease from 24 to 72 months.

Discussion

NEC of the endometrium is a rare disease with poor prognosis, which frequently diagnosed in advanced stages. The main treatment modality was the administration of platinum-based CTX as an adjuvant to surgery or surgery and RT. Our result suggests that the polypoid feature of the tumor might be one of the best predictors for the prognosis of SC NEC.

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Keywords : Neuroendocrine carcinoma, Endometrium, Clinicopathologic features