A 39-year-old woman has a cervical mass biopsied as small cell neuroendocrine carcinoma of the cervix. Imaging shows no distant metastases. Which statement best reflects its management?
- A It is managed identically to squamous carcinoma of the same FIGO stage
- B Even at apparently early stage it behaves systemically, so multimodal therapy including etoposide-platinum chemotherapy is recommended ✓
- C Hormonal therapy with somatostatin analogues is first-line treatment
- D Surgery is contraindicated because of extreme radiosensitivity of the tumour
Correct answer: B. Even at apparently early stage it behaves systemically, so multimodal therapy including etoposide-platinum chemotherapy is recommended
Explanation
Small cell neuroendocrine carcinoma of the cervix is the most aggressive cervical histotype with a high rate of occult distant relapse, so even stage IB disease is treated systemically with etoposide plus platinum alongside locoregional surgery and radiotherapy. Treating it purely by FIGO stage like squamous carcinoma (option A) undertreats micrometastatic disease. Somatostatin analogues target low-grade gastroenteropancreatic NETs, not this poorly differentiated tumour (option C), and surgery remains part of curative-intent multimodal therapy (option D).
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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