J Gynecol Oncol.  2011 Mar;22(1):39-43. 10.3802/jgo.2011.22.1.39.

Pap smear screening for small cell carcinoma of the uterine cervix: a case series and review of the literature

• Park HJ
• Choi YM
• Chung CK
• Lee SH
• Yim GW
• Kim SW
• Nam EJ
• Kim YT

• KMID: 2173584
• DOI: http://doi.org/10.3802/jgo.2011.22.1.39

Abstract

OBJECTIVE
Small cell carcinoma of the uterine cervix (SMCC) is extremely rare, and an aggressive disease that proliferates rapidly. It was often reported that the diagnostic accuracy of cytologic smears in diagnosing SMCC was low. This is a report of the Severance Hospital experience with the patients suffering from SMCC.
METHODS
Twenty-seven patients with small cell carcinoma of the uterine cervix were diagnosed and treated at the Severance Hospital from November 1991 to January 2010. The data were analyzed retrospectively, based on the available charts and pathology reports. Various fields, such as chief complaints and symptoms present at first clinic visit, age, International Federation of Obstetrics and Gynecology (FIGO) clinical stage, treatment modality, the 5-year overall survival rate, and recurrence rate were investigated.
RESULTS
Among the 27 patients diagnosed with small cell carcinoma of the uterine cervix, 18 of them (66.7%) presented with symptoms, including vaginal bleeding, at the first clinic visit, and the remaining 9 patients (33.3%) showed abnormal Pap smear screening in the process of their routine health check-up. The median age of the patients was 54 years (range, 24 to 77 years). FIGO stage IIB was the most common stage (11 of 27 patients). The 5-year overall survival rate of 21 patients, who could be followed up, was 57.2%. Six patients showed recurrence after remission, and the mean disease free interval of them was 9.2 months (range, 6 to 11 months). Abnormal Pap smear screening results of 9 patients was investigated, and the diagnostic accuracy of the cytologic findings was 22.2%.
CONCLUSION
Our study was consistent with the concept that Pap smear screening might not be helpful in early diagnosis of SMCC considering its low diagnostic accuracy. Further large-scale multicenter prospective studies are definitely needed in order to produce abundant information about optimal therapy and diagnosis.

Keyword

Small cell carcinoma; Uterine cervix; Low prevalence; Pap smear; Survival rate; Recurrence

MeSH Terms

Ambulatory Care
Carcinoma, Small Cell
Cervix Uteri
Early Diagnosis
Female
Gynecology
Humans
Mass Screening
Obstetrics
Recurrence
Retrospective Studies
Stress, Psychological
Survival Rate
Uterine Hemorrhage

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