Small-cell neuroendocrine carcinoma of the cervix with leptomeningeal spread - A rare coincidence report and literature review

Sep 21, 2026

Background: Metastasis from cervical cancers to the central nervous system is uncommon, while small-cell neuroendocrine cancer of the cervix is extremely rare and tends to spread early. Case Description: A 33-year-old woman with post-coital bleeding received eight chemotherapy cycles and whole-pelvis consolidation radiotherapy, followed by recurrence with liver, adrenal, and brain metastases. After radiosurgery and immunotherapy, she developed craniospinal leptomeningeal disease with rapid progression and death. Conclusion: Clinicians should maintain a high suspicion for leptomeningeal disease in cervical cancer patients showing unexplained neurologic symptoms, especially in high-grade neuroendocrine types.

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[www.surgicalneurologyint.com](www.surgicalneurologyint.com) Surgical Neurology International Editor-in-Chief: Nancy E. Epstein, MD, Professor of Clinical Neurosurgery, School of Medicine, State U. of NY at Stony Brook. SNI: Neuro-oncology Editor Mitsutoshi Nakada, MD Kanazawa University, Ishikawa, Japan Open Access Case Report Small-cell neuroendocrine carcinoma of the cervix with leptomeningeal spread: A rare coincidence report and literature review Mohammed A. Azab1, Oday Atallah2, Nour El-Gohary3, Ahmed Hazim1, Hamed Abdelma’aboud Mostafa4 1Department of Neurosurgery, Cairo University Hospital, Cairo, Egypt, 2Department of Neurosurgery, Hannover Medical School, Hannover Medical School, Hannover, Germany, 3Department of Neurology, Cairo University Hospital, Cairo, 4Department of Neurosurgery, Hamed Abdelma’aboud Mostafa, AlAzher University, Dameitta, Egypt. E-mail: *[Mohammed A. Azab-mohammed.azab@kasralainy.edu.eg](Mohammed A. Azab-mohammed.azab@kasralainy.edu.eg); [Oday Atallah-oday.atallah@yahoo.de](Oday Atallah-oday.atallah@yahoo.de); [Nour El-Gohary-elgohary.nono@gmail.com](Nour El-Gohary-elgohary.nono@gmail.com); [Ahmed Hazim-ahmedabulnasr@gmail.com](Ahmed Hazim-ahmedabulnasr@gmail.com); Hamed Abdelma’[aboud Mostafa-hamid.12muhmd@gmail.com](aboud Mostafa-hamid.12muhmd@gmail.com) *Corresponding author: Mohammed A. Azab, Department of Neurosurgery, Cairo University Hospital, Cairo, Egypt. mohammed.azab@kasralainy. [edu.eg](edu.eg) | Received: 05 June 2024
Accepted: 06 August 2024
Published: 30 August 2024 | | --- | | DOI
10.25259/SNI_431_2024 | Quick Response Code: ABSTRACT Background: Metastasis from cancers ofthe cervix to the central nervous system is relatively uncommon. Smallcell neuroendocrine cancer of the cervix is a very rare tumor with a high tendency to spread early. Case Description: A 33-year-old-woman was diagnosed with a small-cell neuroendocrine cancer of the cervix after complaining about a long time of post-coital bleeding. 􀀟e patient was treated with eight cycles of chemotherapy and whole pelvis consolidation radiotherapy. One year later, the patient experienced local recurrence with metastases to the liver, left adrenal, and brain. Brain metastases were treated with radiosurgery. 􀀟e patient started immunotherapy. Two months later, the patient was presented to the emergency department with urinary incontinence, neck pain, and difficulty walking. She was then diagnosed with craniospinal leptomeningeal disease (LMD). 􀀟e patient received craniospinal palliative radiation therapy. 􀀟e disease activity was severely progressive, and the patient passed out within 10 days after being diagnosed with cranial LMD. Conclusion: A high index of suspicion for LMD is essential in patients diagnosed with cervix cancer who present with unexplained neurologic symptoms, especially with the high-grade neuroendocrine cancer type. Implementing robust research to uncover the biology of these aggressive tumors is important due to the rarity of this pathology. Keywords: Cervix, Leptomeningeal disease, Metastasis, Neuroendocrine cell cancer INTRODUCTION Leptomeningeal disease (LMD) is characterized by diffuse multifocal involvement of the meninges by cancerous cells. It is considered a lethal complication of malignancy. Cancers that are associated with a high incidence of LMD include melanoma, lymphoma, leukemia, and lung and breast cancer.[1,2,4,19] Recently, the prolonged survival of patients diagnosed with cancer resulted in an increased incidence of LMD. [18,24] Recently, cervical cancer incidence has declined due to the widespread Human papillomavirus (HPV) vaccinations and the regular screening. [6] Neuroendocrine tumors arise from 􀀟is is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the a

FAQs

What is leptomeningeal disease (LMD) in the context of this report?

LMD is characterized by diffuse multifocal involvement of the meninges by cancerous cells and is described as a lethal malignancy complication.

How was the patient initially treated after diagnosis?

She received eight cycles of chemotherapy (carboplatin and etoposide) plus whole-pelvis consolidation radiotherapy, followed by brachytherapy to the cervix and parametrium.

What symptoms led to the emergency presentation after immunotherapy?

She presented with urinary incontinence, neck pain, and difficulty walking, which resulted in a diagnosis of craniospinal leptomeningeal disease.

Sep 21, 2026

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