Serous carcinoma of endometrium in combination with neuroendocrine small-cell: A case report and literature review

• Small-cell carcinoma of endometrium is rare but aggressive and challenging to care.
• We report a case presenting with intermittent post-menopausal bleeding for > 1-month.
• She underwent robotic hysterectomy, BSO, SLN mapping, and complete lymphadenectomy.
• Pathology revealed serous carcinoma of endometrium combined with neuroendocrine SCC.
• To our knowledge, it represents an under-reported area of gynecological medicine.

Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths and recurrences associated with endometrial cancer. Small-cell carcinoma of the endometrium is relatively rare but aggressive, and often presents a component of endometrioid carcinoma, and is not generally associated with serous carcinoma. Herein, we report a case of 74-year-old African-American female, who presented with intermittent post-menopausal bleeding for > 1-month. She underwent robotic-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node mapping, and pelvic-and-aortic lymphadenectomy. Final pathology was consistent with serous carcinoma of the endometrium in combination with neuroendocrine small-cell carcinoma. This extremely rare combination of tumors presents a challenge for treatment. The mainstay of treatment seems to be surgery followed by chemotherapy ± radiation therapy. To our knowledge, it represents an under-reported area of gynecological medicine.