Combined small cell neuroendocrine carcinoma and adenocarcinoma of the uterus:report of a case
ZHANG Zhi-xiu
LU Jin-hai
MA Den-yun
Abstract：Combined small cell neuroendocrine carcinoma-adenocarcinoma of the uterus is rare, with tumor morphology exhibiting typical features of adenocarcinoma and small cell neuroendocrine carcinoma, representing a highly aggressive tumor with a poor prognosis. This case presents combined small cell neuroendocrine carcinoma-adenocarcinoma, with adenocarcinoma components including well-differentiated endometrioid adenocarcinoma and clear cell carcinoma; there are no reports in domestic literature. Under the microscope, the tumor tissue shows two types of cellular morphology: the superficial part exhibits typical adenocarcinoma morphology, with cells arranged in sheets or glandular patterns, some cells showing clear or eosinophilic cytoplasm, with nail-like cells visible, and squamous differentiation seen in some glandular lumens; the deep and myometrial infiltrating tumor tissue shows clusters and sheets of cells, with tumor cells appearing oval, short spindle-shaped, or irregular, intermingled with adenocarcinoma, with deeply stained nuclei, high nuclear-cytoplasmic ratio, indistinct nucleoli, and frequent mitotic figures. The clear cell carcinoma showed diffuse positivity for NapsinA and HNF-1β, the well-differentiated endometrioid adenocarcinoma strongly expressed ER and PR, the squamous differentiation area showed expression of CK5/6, and the small cell neuroendocrine carcinoma showed diffuse strong expression of Syn, CD56, CgA, and SSTR2. Sanger sequencing did not detect mutations in exons of POLE9, 10, 11, 12, 13, and 14 genes.
Keywords：Neuroendocrine CarcinomaPathological DiagnosisImmunohistochemistryMolecular TestingPrognosis
Publication Date：2025-03-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 354-356 )