Small-Cell Carcinoma of the Uterine Cervix Discovered With Quadriplegia Caused by Cervical Spine Metastasis

Abstract

Small-cell carcinoma of the uterine cervix is a rare and aggressive tumor, and the prognosis is poor compared with those of squamous cell carcinoma and adenocarcinoma of the uterine cervix, even when discovered at an earlier stage. We treated a patient with progressive small-cell carcinoma of the uterine cervix that metastasized to the cervical spine. The patient, a 73-year-old woman, presented with the symptom of numbness in her limbs. As she had difficulty moving her limbs (ie, quadriplegia), she was carried to an emergency room. A metastatic cervical spine tumor from the uterine cervical cancer was revealed by a computed tomography scan, and the patient was then transferred to our hospital’s neurosurgery department for treatment. We performed a resection of the cervical spine tumor and fixation of the spinal bone. Because the patient’s performance status was 4 and she remained bedridden 24 h/day, we could not perform systemic chemotherapy. We thus provided palliative care, including palliative radiotherapy, pain control, and rehabilitation to improve her limbs’ functioning. The patient died of the uterine cancer within approx. 6 months after the initiation of treatment. There is no established treatment for small-cell carcinoma as a gynecological lesion. For patients with progressive uterine cancer, the optimal treatments, including palliative care, must be determined.