Introduction/Background Small cell neuroendocrine carcinoma of the cervix is a rare, aggressive malignancy that is accounting about 1–2% of the cervical cancers. The diagnosis of neuroendocrine cervical cancers occurs at an average age of 45 years. There is no standard treatment based on controlled trials because of the rarity of the malignancy. The prognosis is poor, with an overall 5-year survival rate of about 35%.

Methodology We report the case of a 33-years old woman with an exophitic tumour of the cervix. The cervical biopsy showed a small cell neuroendocrine carcinoma. The CT-Scan of the chest and abdomen showed enlarged retroperitoneal lymph nodes and the large cervical tumour. The case was presented in the local tumour board (cT1B3, cN1, M0, G3/FIGO IIIC1), it was decided to start neoadjuvant treatment with Carboplatin AUC6 day 1 and Etoposide 120 mg/m² days 1–3. After 4 cycles we confirmed gut clinical response with local regression in the pelvic MRI. We performed a radical hysterectomy with BSO and pelvic and paraaortal lymph node dissection. After histopathological work-up the tumour regression was confirmed: ypT1B1, pN1 (3/75), M0, L1, V0, Pn1. It followed the second discussion in the local tumour board. We decided a treatment with 2 additional cycles of Carboplatin and Etoposide followed by chemoradiotherapy, which were applied sequentially.

Results The follow-up controlls up to 8 months after surgery showed no signs of cancer recurrence.

Conclusion Our observation confirms that cervical neuroendocrine small-cell carcinoma is a chemosensitive tumor. For tumours which are primarily not suitable for operation neoadjuvant chemotherapy should be started, followed by radical surgery when applicable.