Primary Large Cell Neuroendocrine Carcinoma of the Uterus: A Case Report and Literature Review

Large cell neuroendocrine carcinomas (LCNEC) of the uterus is a rare and very aggressive neoplasm. Herein we report a case of large cell neuroendocrine carcinoma arising from the uterus with extensive carcinomatosis. The patient was a 51-year-old African-American female who presented with increasing worsening abdominal distension and abdominal pain over a period of one month.  A computed tomography (CT) imaging study disclosed a 20 x 15 x 10 cm heterogeneous uterine mass with significant ascites and omental thickening. The patient subsequently underwent a total hysterectomy with bilateral salpingo-oophorectomy and omental resection. Histological examination showed a large cell neuroendocrine carcinoma with extensive necrosis and numerous abnormal mitosis. No associated surface epithelial component was identified. Immunohistochemical staining pattern was consistent with the neuroendocrine origin. The patient’s condition rapidly deteriorated postoperatively, and she died one month later due to multi-organ complications. In light of the rarity of LNEC arising from the uterus, a comprehensive review of the literature is discussed.  [N A J Med Sci. 2018;11(1):39-42.   DOI: 10.7156/najms.2018.1101039]