# Leptomeningeal metastasis from large-cell neuroendocrine carcinoma of the cervix: a case report and literature review **Authors:** Peng Xu, Zhen-Jiang Wang, Xin-Mei Dang, Bao-Yu Zhu, Zhang-Cai Zheng PMC · DOI: 10.3389/fonc.2026.1734305 · Frontiers in Oncology · 2026-02-13 ## TL;DR This paper reports a rare case of leptomeningeal metastasis from cervical cancer and discusses its diagnosis and treatment. ## Contribution The paper presents a rare clinical case and treatment approach for leptomeningeal metastasis from neuroendocrine cervical carcinoma. ## Key findings - Leptomeningeal metastasis from neuroendocrine cervical carcinoma is extremely rare, with only five cases reported. - Intrathecal chemotherapy combined with oral temozolomide was used to treat leptomeningeal metastasis in this case. - The case highlights the challenges in managing metastatic cervical cancer with neurological complications. ## Abstract Leptomeningeal metastasis (LM) from neuroendocrine carcinoma of the cervix (NECC) is extremely rare, with only five cases reported in the literature. Immune checkpoint inhibitors (ICIs) have the standard first-line treatment for metastatic cervical carcinoma and have been reported to improve intracranial response and survival in several types of cancer. A 50-year-old woman initially received pelvic radiation and chemotherapy for cervical cancer. At 1 year later, she complained of left breast, supraclavicular, and retroperitoneal lymph node metastases. She received targeted and adjuvant chemotherapy. At 15 months after diagnosis, she received radiotherapy due to nasopharynx and supraclavicular lymph node metastasis as well as treatment with a bispecific antibody targeting PD-1 and CTLA-4, cadonilimab, combined with chemotherapy. At 20 months after diagnosis, she experienced a transient unconsciousness and severe headache, nausea, and vomiting. The cytological demonstration of malignant cells in the cerebrospinal fluid (CSF) confirmed the presence of leptomeningeal metastasis. The therapeutic regimen then consisted of intrathecal chemotherapy combined with oral temozolomide. The authors highlight the diagnosis and treatment of LM from NECC, providing a rare clinical scenario. ## Linked entities - **Chemicals:** temozolomide (PubChem CID 5394) - **Diseases:** leptomeningeal metastasis (MONDO:0700219), cervical cancer (MONDO:0002974) ## Full-text entities - **Genes:** CDKN2A (cyclin dependent kinase inhibitor 2A) [NCBI Gene 1029] {aka ARF, CAI2, CDK4I, CDKN2, CMM2, INK4}, CHGA (chromogranin A) [NCBI Gene 1113] {aka CGA, PHE5, PHES}, ENO2 (enolase 2) [NCBI Gene 2026] {aka HEL-S-279, NSE}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, NCAM1 (neural cell adhesion molecule 1) [NCBI Gene 4684] {aka CD56, MSK39, NCAM}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, SYNM (synemin) [NCBI Gene 23336] {aka DMN, SYN}, MUC16 (mucin 16, cell surface associated) [NCBI Gene 94025] {aka CA125}, CTLA4 (cytotoxic T-lymphocyte associated protein 4) [NCBI Gene 1493] {aka ALPS5, CD, CD152, CELIAC3, CTLA-4, GRD4} - **Diseases:** neuroendocrine tumors (MESH:D018358), spinal cord lesions (MESH:D013118), necrosis (MESH:D009336), neurological (MESH:D009461), carcinomatous meningitis (MESH:D055756), hearing loss (MESH:D034381), impaired right-eye abduction function (MESH:D005128), seizure (MESH:D012640), hydrocephalus (MESH:D006849), cranial neuropathies (MESH:D003389), nasopharyngeal carcinoma (MESH:D000077274), solid (MESH:D018250), Infectious meningitis (MESH:D003141), cervical malignancies (MESH:D002575), vomiting (MESH:D014839), Paraneoplastic syndromes (MESH:D010257), auditory neurological symptoms (MESH:D009422), low back pain (MESH:D017116), large cell neuroendocrine carcinoma of the cervix (MESH:D018287), NSCLC (MESH:D002289), nausea (MESH:D009325), spinal-nerve-related symptoms (MESH:D061227), sciatic nerve injury (MESH:D020426), breast cancer (MESH:D001943), lymph node (MESH:D000072717), lymphoma (MESH:D008223), Sensory loss (MESH:C580162), fatigue (MESH:D005221), malignant meningitis (MESH:D008577), sensory disturbances (MESH:D012678), cancer (MESH:D009369), tinnitus (MESH:D014012), unconsciousness (MESH:D014474), lung cancer (MESH:D008175), neurotoxicity (MESH:D020258), infection (MESH:D007239), Neuroendocrine carcinoma of the cervix (MESH:D018278), meningeal (MESH:D008580), Neck stiffness (MESH:D006258), toxicity (MESH:D064420), melanoma (MESH:D008545), epileptic seizures (MESH:D004827), small cell neuroendocrine carcinoma of the cervix (MESH:D018288), LM (MESH:D009362), dysphagia (MESH:D003680), pituitary inflammation (MESH:D007249), headache (MESH:D006261), leukemia (MESH:D007938), hypophysitis (MESH:D000072659), hypopituitarism (MESH:D007018), pharyngeal pain (MESH:D010612), cervical cancer (MESH:D002583) - **Chemicals:** nivolumab (MESH:D000077594), eosin (MESH:D004801), ipilimumab (MESH:D000074324), folate (MESH:D005492), chloride (MESH:D002712), glucose (MESH:D005947), bevacizumab (MESH:D000068258), PD (MESH:D010165), pembrolizumab (MESH:C582435), paclitaxel (MESH:D017239), Temozolomide (MESH:D000077204), dexamethasone (MESH:D003907), etoposide (MESH:D005047), H&E (MESH:D006371), cisplatin (MESH:D002945), platinum (MESH:D010984), EP (-), paraffin (MESH:D010232), Pemetrexed (MESH:D000068437), hematoxylin (MESH:D006416) - **Species:** Human papillomavirus 16 (serotype) [taxon 333760], Homo sapiens (human, species) [taxon 9606] ## Full text _Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12945753/full.md ## Figures 5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12945753/full.md ## References 42 references — full list in the complete paper: https://tomesphere.com/paper/PMC12945753/full.md --- Source: https://tomesphere.com/paper/PMC12945753