title: Small cell carcinoma of the urinary bladder. A clinicopathologic analysis of 22 cases.
abstract: Small cell carcinoma of the urinary bladder is an uncommon tumor. The authors report the clinicopathologic findings in a series of 22 cases. Fifteen men and 7 women were studied; their ages ranged from 51 to 87 years (mean, 62.4 years). The most frequent presentation was hematuria (94.4%). At diagnosis, three patients had Stage B disease, six had Stage C, and ten had Stage D (unknown stage in three). Histologically, 6 were oat cell type tumors, 11 were of intermediate cell type, and 5 were of combined cell type. Immunohistochemical studies demonstrated positivity for neuron-specific enolase in ten of ten cases, cytokeratin in seven of ten cases, chromogranin in eight of nine cases, serotonin in seven of nine cases, and S-100 protein in four of ten cases. Neuroendocrine differentiation was seen in five of seven cases examined by electron microscopy. Treatment and follow-up data were available for 19 patients: 10 (52.6%) were dead of disease, 5 (26.3%) were alive and well, 3 (15.8%) were alive with disease, and 1 (5.3%) died of an unrelated cause. The 2-year survival rate was 50% for patients with Stage B, 25% for patients with Stage C, and 33% for patients with Stage D disease. Although overall survival was poor, some cases responded well to therapy. Based on the authors' experience, radical cystectomy with adjuvant chemotherapy appears to be the treatment of choice.
authors.affiliation: Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
authors.forename: D J
authors.initials: DJ
authors.lastname: Grignon
authors.forename: J Y
authors.initials: JY
authors.lastname: Ro
authors.forename: A G
authors.initials: AG
authors.lastname: Ayala
authors.forename: D T
authors.initials: DT
authors.lastname: Shum
authors.forename: N G
authors.initials: NG
authors.lastname: Ordóñez
authors.forename: C J
authors.initials: CJ
authors.lastname: Logothetis
authors.forename: D E
authors.initials: DE
authors.lastname: Johnson
authors.forename: B
authors.initials: B
authors.lastname: Mackay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000737:chemistry / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure