Re: Small-Cell Neuroendocrine Carcinoma of the Cervix Masquerading as a Cervical Fibroid Report of a rare entity
Journal Title: Sultan Qaboos University Medical Journal - Year 2018, Vol 18, Issue 2
Abstract
I read with interest the recent case report by Pujani et al. published in the February 2018 issue of SQUMJ in which the authors describe a case of small-cell neuroendocrine carcinoma (SNEC) of the cervix in a 44-year-old Indian woman.1 I presume, given the rarity of this condition and the highly aggressive nature of the tumour, the authors have considered that the reported patient may have had an altered immune status.1 In India, HIV infection is a sizable health problem, with available data indicating a heightened seroprevalence of 0.26% compared to the global average of 0.2%.2 Among those with altered immune states, HIV status is of the utmost importance. My presumption is based on the fact that HIV-infected patients are more vulnerable to various types of tumours compared to immunocompetent individuals. Tis increased vulnerability has been attributed to various factors, including suppressed immunity, associated infection with oncogenic viruses and prolonged life expectancy due to antiretroviral treatment.3 High rates of cervical cancer have been reported among HIV-infected patients.4 Furthermore, genital cancers are found to occur in a substantial proportion of HIV-infected women in India.5 Hence, a diagnostic blood workup, cluster of differentiation (CD)4 count and viral overload measurements should have been conducted in order to determine the HIV status of the reported patient.1 If the patient was subsequently found to have an HIV infection, the case in question would surely be considered novel as, to the best of my knowledge, HIV-associated SNEC of the cervix has not been reported in the literature to date.
Authors and Affiliations
Mahmood D. Al-Mendalawi
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