Pregnancy-preserving and maternal-fetal management in a patient with rare large cell neuroendocrine carcinoma of the uterine cervix

• Published in: Nan fang yi ke da xue xue bao = Journal of Southern Medical University 2021-01, Vol.41 (1), p.1-9
• Main Authors: Geyang, Dai, Gaowen, Chen, Xiaoxuan, L I, Youhong, Zheng, Yuan, Wang, Xingsong, Li, Jing, L I, Jing, Zhou, Yu, Xie, Yifeng, Wang
• Format: Article
• Language: Chinese
• Subjects: Adenocarcinoma; Adult; Carcinoma, Neuroendocrine - genetics; Child; Female; Humans; Infant, Newborn; Neoplasm Recurrence, Local; Pregnancy; Uterine Cervical Neoplasms - genetics
• ISSN: 1673-4254
• DOI: 10.12122/j.issn.1673-4254.2021.01.01

To explore the strategy of pregnancy-preserving and maternal- fetal management in patients with primary gynecologic neuroendocrine tumors (gNETs) during pregnancy. We performed whole genome sequencing (WGS) for analyzing maternal and fetal somatic and germline single nucleotide variations (SNVs) and small insertions and deletions (InDels) for a 29-year-old pregnant woman diagnosed with stage IB2 large cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the cervix. A systematic literature review was performed to explore the strategies for treatment of such rare histological type while maintaining pregnancy. Global case analysis of cervical NETs during pregnancy suggested that negative lymph node metastasis and an early FIGO stage were potentially associated with a good prognosis of the patients. In the case presented herein, a pregnancy-preserving strategy was adopted and favorable maternal-fetal outcomes were achieved after neoadjuvant chemotherapy, radical surgery and postoperative systemic chemother