A 33-year-old woman presents with abnormal uterine bleeding. Biopsy of a firm, barrel-shaped cervix reveals small round blue cells with scant cytoplasm, nuclear moulding, and abundant mitoses; immunohistochemistry is positive for chromogranin and synaptophysin. Which statement about management is correct?

• A It behaves like other early cervical cancers, so radical hysterectomy alone suffices
• B It is hormone receptor positive and responds to tamoxifen therapy
• C It is managed like small cell lung cancer, with platinum plus etoposide chemotherapy added to local therapy ✓
• D It has the best prognosis among cervical cancer histological subtypes

Explanation

This is primary neuroendocrine (small cell) carcinoma of the cervix, an aggressive subtype with early lymphovascular and haematogenous spread. Because its behaviour mirrors pulmonary small cell carcinoma, systemic chemotherapy with a platinum agent plus etoposide is combined with surgery or chemoradiation depending on stage. Radical surgery alone fails due to distant relapse, which kills option A. It carries one of the worst prognoses among cervical histologies.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.