A potential role for intensive chemotherapy in the treatment of small cell neuroendocrine tumors of the cervix.

Small cell neuroendocrine (SCNE) tumors of the cervix constitute a group of malignancies with a predilection for early systemic metastasis which likely contributes to the poor outcome reported to date. Histologic and immunocytochemical similarities exist between SCNE cervical tumors and small cell (oat cell) tumors of the lung. Notable clinical responses to chemotherapy have been reported in both small cell lung tumors and in poor-risk squamous cervical cancers, suggesting the potential for a similar role in the management of SCNE cervical tumors. In this report, four cases are described in which intensive chemotherapy with etoposide, doxorubicin, and cisplatin was used in patients with SCNE tumors. Marked reduction in tumor volume was a feature in three evaluable patients, two of whom received neoadjuvant therapy (one complete and one near-complete pathologic response). The fourth patient received adjuvant chemotherapy and remains without evidence of disease 47 months from diagnosis. Management details of each case have been provided along with a review of the use of chemotherapy in SCNE cervical tumors.