Abstract

Ten cases of small cell carcinoma of the uterine cervix are described. The mean age of the patients was 58 years. Seven patients had stage IB disease, two had IIA and one IIB. Eight patients died of disease (mean survival 1.7 years) and two are alive with widespread metastases. Most of the tumors were bulky masses (>4 cm) and 50% of them involved the entire cervical circumference. The depth of stromal invasion ranged from 50-100% with a mean of 65%.

Microscopically, all carcinomas show monotonous small to intermediate size cells arranged in irregular sheets. Focal glandular differentiation (less than 10%) was present in two, focal squamous differentiation in one. All tumors were positive for one or more neuroendocrine markers. Three patients with the shortest survival (mean 0.3 years) had p53 positive tumors. BCL-2 and/or CD-44 positivity was more common, detected in nine of 10 carcinomas. The only chemosensitive tumor had negative staining for all three markers. Overexpression of p53, BCL-2 and CD-44 in small cell carcinoma of the cervix may explain its poor response to treatment and may help to direct therapy in the future.