Neuroendocrine Carcinoma Of The Endometrium:A Report Of 5 Cases And Literature Review

ObjectiveTo investigate the epidemiological characteristics,pathologic type,etiology and pathogenesis,clinical manifestations,treatment and prognosis of neuroendocrine carcinoma of the endometrium,so as to guide clinical practice.MethodsCollect 5 cases of neuroendocrine carcinoma of the endometrium which were diagnosed by pathology and immunohistochemistry in Tianjin First Central Hospital and combine with literature review to get the clinical analysis,discussion and summary.Results1.Age of onset: Within the 5 patients,the youngest is 52 years old and the oldest is 72 years old.2.Menstrual status: Within the 5 patients,1 patient is in perimenopausal period and the other 4 patient were postmenopausal.The shortest time in menopause was 6years,the longest time in menopause was 22 years.3.The clinical manifestation and diagnosis: Within the 5 patients,1 patient who was in perimenopausal period showed irregular menstruation for 3 years,vaginal bleeding for 5 months.4 postmenopausal patients showed vaginal bleeding,the longest course of the disease was 2 years,the shortest one was 12 days.All patients were diagnosed as endometrial carcinoma by endometrial biopsy,of which 1 cases of endometrial biopsy were diagnosed as SCNEC of the endometrium,and the other 4cases were suggested as endometrioid adenocarcinoma in endometrium biopsy.In these 4 cases,the existence of NEC of the endometrium was confirmed after surgery.Within the 5 cases,2 were SCNEC,1 was SCNEC mixed with LCNEC,and2 were only suggested as NEC.Within the 5 patients,1 was simple SCNEC,3 were mixed with endometrioid adenocarcinoma,and 1 was mixed with endometrial adenosine carcinoma.4.Surgical pathology stage and treatment: All of the patients underwent surgical pathology stage,including IB stage 1 case,IIIB stage 1 cases,IIIC stage 1 cases,IVB stage 2 case.1-6 cyles of chemotherapy were given after surgery,and chemotherapy regimen was paclitaxel and carboplatin.5.Follow-up and prognosis: Within the 5 patients,we follow up for 9-24 months,4 patients had no recurrence and 1 patient died.Conclusions1.Neuroendocrine carcinoma of the endometrium usually occurs in postmenopausal women.The SCNEC of the endometrium is more common than LCNEC of the endometrium.2.The course of disease is short and the progress is fast.Most patients were at the late stage when diagnosed.The chemotherapy after surgery is of great significance for improving the prognosis.However,more clinical data is needed to be accumulated to guide clinical treatment.