title: Brain metastasis from large cell neuroendocrine carcinoma of the urinary bladder.
abstract: BACKGROUND
  In patients with urinary bladder cancer, brain metastases are quite rare and occur in only 1-7% of these patients. Of the urinary bladder cancers, large cell neuroendocrine carcinoma (LCNEC) is extremely rare; only 16 cases have been reported to date. In this report, a case of brain metastasis from LCNEC of the urinary bladder is described.
  
  
  METHODS
  A 74-year-old man was admitted with confusion and left-sided hemiparesis. Head magnetic resonance imaging demonstrated a ring-enhancing lesion in the right frontal lobe. Whole body computed tomography revealed a suspicious lesion in the urinary bladder. These findings were considered consistent with metastatic brain tumor. Craniotomy and tumor removal were performed. After craniotomy, the patient underwent cystoscopy and the bladder mass was biopsied. Histological and immunohistochemical examination of both the brain tumor and bladder mass revealed LCNEC. According to these findings, the patient was diagnosed with a brain metastasis from LCNEC of the urinary bladder.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of a patient with a brain metastasis from LCNEC of the urinary bladder.
authors: Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
authors: Atsushi
authors: A
authors: Tsugu
authors: Michitsura
authors: M
authors: Yoshiyama
authors: Mitsunori
authors: M
authors: Matsumae