Neuroendocrine Tumors of the Endometrium: a Case Series with Clinico-Pathological Analysis and Review of Literature

Neuroendocrine carcinomas are rare aggressive tumors that are either mixed with endometrial carcinomas or pure neuroendocrine carcinoma. They show at least one or two neuroendocrine markers by immunohistochemistry. Here, we describe a case series of six cases that arise from endometrium. The mean age of presentation was 57 years with the most common type being mixed endometrioid and neuroendocrine carcinoma. Immunohistochemistry showed all cases positive for Pan-cytokeratin and INSM-1 while the majority were positive for synaptophysin and chromogranin. At least two neuroendocrine markers were positive in all cases in > 20% of tumor cells. The majority of the cases presented at FIGO (International Federation of Gynecology and Obstetrics) Stage III & IV. Three patients had a recurrence, one patient had bone metastasis, one patient died, and one patient was free of disease. Four patients with Stage IV disease were not alive for more than 18 months. A multidisciplinary approach is required for these aggressive tumors for better management of patients.