Case Report: Diagnostic Challenges in Cervical Small Cell Neuroendocrine Carcinoma of a Reproductive-Age Woman

Yitong Du¹Huiling Yang¹Yichen Feng¹Zejun Wu^1,2Mengyao Li²Tingting Zhu²Yali Zhuang^1,2*

• ¹Anhui Medical University, Hefei, China
• ²Department of Obstetrics and Gynecology, Anhui Women and Children’s Medical Center, Hefei, China

Small cell neuroendocrine carcinoma of the cervix (SCNEC) is a rare and highly aggr essive malignancy with a poor prognosis. We report the case of a 36-year-old nullipar ous woman with a history of HPV-18 infection and repeated cytology showing atypic al squamous cells of undetermined significance (ASC-US), while multiple biopsies rem ained negative. She initially underwent surgery for multiple uterine leiomyomas and se vere endometriosis. Ten months later, she presented with acute pelvic pain, rectal pres sure, and minor vaginal bleeding. Combined hysteroscopy and laparoscopy revealed su spicious lesions, and histopathology with immunohistochemistry confirmed International Federation of Gynecology and Obstetrics (FIGO) stage IVB SCNEC. Postoperatively, she received platinum-based chemotherapy followed bysalvage immunotherapy. Despit e a transient decline in tumor markers, the disease progressed rapidly, with enlargeme nt and confluence of pelvic lesions and extensive bone metastases, ultimately resulting in death from multi-organ failure. This case highlightsthe diagnostic challenges, early systemic dissemination, and dismal outcomes of SCNEC, underscoring the urgent nee d for more effective therapeutic strategies.