Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2023; 11(21): 5160-5166
Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5160
Neuroendocrine carcinoma of the endometrium concomitant with Lynch syndrome: A case report
Wing Yu Sharon Siu, Mun-Kun Hong, Dah-Ching Ding
Wing Yu Sharon Siu, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
Mun-Kun Hong, Minimally Invasive Gynecology Surgery Center, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Ch University, Hualien 970, Taiwan
Author contributions: Ding DC contributed to conceptualization, methodology, contributed to writing —review and editing; Siu WYS contributed to formal analysis, Siu WYS and Hong MK contributed to data curation; Siu WYS and Ding DC contributed to writing —original draft preparation; All the authors have read and agreed to the published version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient to publish this paper.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dah-Ching Ding, MD, PhD, Professor, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Ch University, No. 707 Chung-Yang Road, Sec. 3, Hualien 970, Taiwan. dah1003@yahoo.com.tw
Received: May 9, 2023
Peer-review started: May 9, 2023
First decision: June 13, 2023
Revised: June 14, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: July 26, 2023
Abstract
BACKGROUND

Large-cell neuroendocrine carcinoma (NEC) is an uncommon type of tumor that can occur in the endometrium. This aggressive cancer requires definitive management. Here, we describe the clinical characteristics and treatment of a postmenopausal woman with large cell NEC of the endometrium.

CASE SUMMARY

A 55-year-old Asian female presented with a 1-year history of postmenopausal vaginal bleeding. Transvaginal ultrasound revealed a thickened endometrium (30.2 mm) and a hypervascular tumor. Computed tomography revealed that the tumor had invaded more than half of the myometrium and spread to the pelvic lymph nodes. The tumor marker, carcinoembryonic antigen, was elevated (3.65 ng/mL). Endocervical biopsy revealed high-grade endometrial carcinoma. She underwent radical hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and bilateral pelvic and para-aortic lymph node dissection. Pathological examination revealed mixed neuroendocrine and endometrioid adenocarcinoma, pT2N0M0, grade 3, and International Federation of Gynecology and Obstetrics stage 2. Immunohistochemistry showed moderate estrogen and progesterone receptor expressions (20% and 1%, respectively), focal CD56 expression (NEC marker), positive staining for vimentin, p53 (wild type), and ki67 (90%), and loss of expression of PMS2 (Lynch syndrome marker). The patient received five cycles of cisplatin and etoposide after surgery. No recurrence was noted after 5 mo.

CONCLUSION

We report the characteristics and successful management of a rare case of large-cell endometrial NEC concomitant with Lynch syndrome.

Keywords: Neuroendocrine carcinoma, Endometrium, Large cell carcinoma, Immunohistochemistry, Lynch syndrome, Case report

Core Tip: Here, we report a case of large-cell neuroendocrine carcinoma (NEC) of the endometrium. We have updated information on NEC regarding its symptoms, signs, diagnosis, and treatment. Due to the rarity of endometrial NEC, we provide a strategy for diagnosing and treating this type of endometrial cancer.