Primary small cell ovarian cancer of pulmonary type: A case report

Small-cell neuroendocrine carcinoma of the female genital tract: A comprehensive overview

Small-cell neuroendocrine carcinomas (SCNECs) of the female genital tract are rare and aggressive tumors that are characterized by a high rate of recurrence and poor prognosis. They can arise from various sites within the female genital tract, including the cervix, endometrium, ovary, fallopian tube, vagina, and vulva. They are composed of cells with neuroendocrine features, such as the ability to produce and secrete hormones and peptides, and a high mitotic rate. Immunohistochemical staining for neuroendocrine markers, such as chromogranin A, synaptophysin, and CD56, can aid in the diagnosis of these tumors. This article provides an overview of the epidemiology, etiology, and risk factors associated with these tumors, as well as their clinical presentation, cellular characteristics, diagnosis, and finally the current treatment options for SCNECs, including surgery, chemotherapy, and radiation therapy, alone or in combination.

Small cell carcinoma of the ovary, pulmonary type: A role for adjuvant radiotherapy after carboplatin and etoposide?

•

Small cell carcinoma of the ovary, pulmonary type (SCCOPT) is a rare malignancy requiring a thorough diagnostic evaluation.

•

Adjuvant radiation therapy was successfully used for residual bulky adenopathy after chemotherapy in a patient with SCCOPT.

•

Extrapolating treatment strategies from similar histologies of other primary sites may be beneficial in rare tumors.

Background

Primary small cell ovarian cancer of pulmonary type (SCCOPT) remains a rare ovarian tumor. Its aggressive nature is associated with poor survival outcomes. Current treatment algorithms rely on systemic chemotherapy, primarily involving platinum agents. However, given its low incidence, less is known about the potential benefits of other treatments.

Case Presentation

We report a case of an 80-year-old woman who was found to have a complex pelvic mass with a mildly elevated CA-125. She underwent a laparotomy for staging with tumor debulking; she had bulky unresectable adenopathy and pathology was consistent with stage IIIC SCCOPT. Postoperative imaging revealed progression of disease. She received six cycles of carboplatin and etoposide followed by consolidative radiation therapy to her para-aortic lymph nodes. She remains disease-free for over four years after completion of adjuvant therapy.

Discussion

Histologically, SCCOPT resembles small cell carcinomas of the lung, which are treated with a combination of chemotherapy and radiation therapy. New approaches that build upon the current treatment approaches and incorporate strategies from non-gynecologic tumor types could be beneficial.

A Rare Presentation of Dual Ovarian Pathologies: Small Cell Carcinoma of the Ovary and Mucinous Ovarian Cancer

The small cell carcinoma of ovaries co-occurring with mucinous ovarian cancer is a rare event. We report a 21-years-old lady with a composite tumour comprising small cell carcinoma and mucinous carcinoma of ovaries. The incidental finding of the left ovarian cyst led to further workup and revealed a solid cystic mass in the left adnexal area pathologically proven to be mucinous ovarian carcinoma. The initial surgery was deferred upon the patient's request. After a few more cycles of chemotherapy, at the completion of surgery as per ovarian protocol, the pathological evaluation showed small cell carcinoma in the left ovary with a residual focus of mucinous carcinoma.

In contrast, the right ovary also showed surface deposits of small cell carcinoma. The patient's clinical condition deteriorated very rapidly after that, and she passed away. Early recognition of small cell carcinoma in a composite tumour is critically essential for timely intervention.

A Case of Lethal Abdominal Compartment Syndrome due to Rapidly Expanding Ovarian Small Cell Carcinoma Pulmonary Type

A 53-year-old woman presented with a rapidly growing pelvic mass suspected to be endometrial cancer due to endometrial biopsy showing grade 1 endometrioid adenocarcinoma. Due to severe aortic valve stenosis, she underwent a transcatheter aortic valve replacement (TAVR) for surgical optimization for a planned total abdominal hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking. She was discharged on dual antiplatelet therapy with plans for future surgery, but was readmitted with abdominal distension, constipation, and urinary retention. The pelvic mass seen on prior imaging studies had increased in size. Unanticipated asystole cardiac arrest occurred two days after readmission, which on autopsy was found to be secondary to abdominal compartment syndrome from a rapidly enlarging ovarian small cell carcinoma pulmonary type.