Emerging Therapeutic Concepts and Latest Diagnostic Advancements Regarding Neuroendocrine Tumors of the Gynecologic Tract
Tiberiu-Augustin Georgescu,
Roxana Elena Bohiltea,
Octavian Munteanu,
Florentina Furtunescu,
Antonia-Carmen Lisievici,
Corina Grigoriu,
Florentina Gherghiceanu,
Emilia Maria Vlădăreanu,
Costin Berceanu,
Ionita Ducu,
Ana-Maria Iordache
Affiliations
Tiberiu-Augustin Georgescu
Discipline of Pathology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
Roxana Elena Bohiltea
Discipline of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
Octavian Munteanu
Department of Obstetrics and Gynecology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
Florentina Furtunescu
Department of Public Health and Management, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
Antonia-Carmen Lisievici
Discipline of Pathology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
Corina Grigoriu
Discipline of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
Florentina Gherghiceanu
Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Emilia Maria Vlădăreanu
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, Romania
Costin Berceanu
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
Ionita Ducu
Department of Obstetrics and Gynecology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
Ana-Maria Iordache
Optospintronics Department, National Institute for Research and Development in Optoelectronics-INOE 2000, 409 Atomistilor, 077125 Magurele, Romania
Neuroendocrine neoplasms (NENs) are particularly rare in all sites of the gynecological tract and include a variety of neoplasms with variable prognosis, dependent on histologic subtype and site of origin. Following the expert consensus proposal of the International Agency for Research on Cancer (IARC), the approach in the latest World Health Organization (WHO) Classification System of the Female Genital Tumours is to use the same terminology for NENs at all body sites. The main concept of this novel classification framework is to align it to all other body sites and make a clear distinction between well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). The previous WHO Classification System of the Female Genital Tumours featured more or less the same principle, but used the terms ‘low-grade neuroendocrine tumor’ and ‘high-grade neuroendocrine carcinoma’. Regardless of the terminology used, each of these two main categories include two distinct morphological subtypes: NETs are represented by typical and atypical carcinoid and NEC are represented by small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC). High-grade NECs, especially small cell neuroendocrine carcinoma tends to be more frequent in the uterine cervix, followed by the endometrium, while low-grade NETs usually occur in the ovary. NENs of the vulva, vagina and fallopian tube are exceptionally rare, with scattered case reports in the scientific literature.