Small cell neuroendocrine tumour of the cervix in pregnancy: the importance of multidisciplinary management.
Esme BainSarah Louise ColeridgeJo MorrisonPublished in: BMJ case reports (2021)
A woman in her mid-20s presented with bleeding at 18 weeks gestation from a cervical 'polyp'. Histopathology demonstrated a rare small cell neuroendocrine of the cervix. There were only 18 cases of neuroendocrine tumours of the cervix in and around pregnancy in the literature, so the evidence base for treatment was scarce. She was treated with neoadjuvant chemotherapy, using a regimen used for small cell neuroendocrine tumours of the lung, to allow for fetal lung maturity. Disease initially responded, then progressed and she was delivered at 32 weeks by caesarean radical hysterectomy. Adjuvant treatment included further chemotherapy and radical pelvic radiotherapy. The woman and her child are doing well over 6 years after treatment, although the woman has significant side effects of both radical surgery and radiotherapy. This case emphasises the need for excellent communication between multidisciplinary professionals, patients and their families and using external colleagues to help with rare clinical problems.
Keyphrases
- locally advanced
- neoadjuvant chemotherapy
- preterm birth
- early stage
- single cell
- rectal cancer
- cell therapy
- newly diagnosed
- systematic review
- mental health
- radiation therapy
- lymph node
- minimally invasive
- squamous cell carcinoma
- ejection fraction
- radiation induced
- case report
- prognostic factors
- quality improvement
- coronary artery disease
- pregnant women
- coronary artery bypass
- pregnancy outcomes
- bone marrow
- patient reported outcomes
- combination therapy
- replacement therapy