PT  - JOURNAL ARTICLE
AU  - Bonetti, Heloise Serafin
AU  - de Sousa, Carla Baltazar
AU  - Sartorelli, Vivian
AU  - Baptista da Silva, Renan Tapigliani
AU  - de Almeida, Thais Gomes
AU  - de Souza Pinto, Gabriel Lowndes
AU  - de Farias e Silva, Andre Lopes
AU  - Guilherme, Andriolli
AU  - Persiano, Marcella Bastos
AU  - D’Elia, Giovana Mortari
AU  - Garcia, Rafaela Debastiani
AU  - Vieira Sales, Maria Jannine
AU  - Cardoso, Amanda Horie
AU  - Cintra, Georgia Fontes
TI  - 2022-RA-1541-ESGO Small cell neuroendocrine tumor of the cervix with multiple cutaneous metastasis: a report of 2 cases
AID  - 10.1136/ijgc-2022-ESGO.138
DP  - 2022 Oct 01
TA  - International Journal of Gynecologic Cancer
PG  - A63--A64
VI  - 32
IP  - Suppl 2
4099  - http://ijgc.bmj.com/content/32/Suppl_2/A63.2.short
4100  - http://ijgc.bmj.com/content/32/Suppl_2/A63.2.full
SO  - Int J Gynecol Cancer2022 Oct 01; 32
AB  - Introduction/Background Small cell neuroendocrine carcinoma of the cervix (SCNCC) is an aggressive and rare histological variant. It has a reserved prognosis with 34% survival in 5 years. The most common sites of metastasis are lymph nodes, liver, lung and brain. Cutaneous metastasis are extremely rare, with reported incidence of 0.1%, mostly in surgical incision. Multimodal treatment is usually indicated due to its poor prognosis.Methodology We present a report of two cases of SCNCC with multiple cutaneous metastasis.Results Patient 1: Previously healthy 43 years old, with normal screening for cervical cancer 16 months prior to admission, presented with vaginal discharge, pelvic pain and weight loss. Physical exam revealed multiple cutaneous nodules and a bulky cervical tumor. Imaging revealed diffuse lymph node metastasis and numerous cutaneous lesions.Patient 2: Previously healthy 59 years old, presented with similar symptoms and physical exam, but also a rectovaginal fistula. Imaging revealed metastatic disease to the lymph nodes, peritoneum, bone, brain and numerous cutaneous lesions.Both patients underwent cervical tumor and cutaneous nodules biopsy, confirming a SCNCC with cutaneous metastasis. Patient 2 had an initial report of Merkel carcinoma and only after pathological review metastatic SCNCC was confirmed. Hypofractioned pelvic radiotherapy was performed to control local symptoms and before initiation of palliative chemotherapy, both evolved quickly to diffuse progressive disease. Chemotherapy with carboplatin associated with paclitaxel and etoposide was initiated and the patient with cerebral metastasis also received whole brain radiotherapy. Patient 1 died of the disease 9 months after diagnosis and patient 2 is alive with disease with a follow-up of 13 months, still receiving palliative treatment.Abstract 2022-RA-1541-ESGO Figure 1 Left image refers to patient 1 and right image refers to patient 2, both presenting subcutaneous nodulesConclusion We present 2 cases of an extremely rare presentation of SCNCC with multiple cutaneous metastasis. In this aggressive subtype, meticulous physical exam is paramount and any abnormal finding should prompt further investigation.