title: Small cell carcinoma of the renal pelvis and ureter: clinicopathologic and immunohistochemical features.
abstract: BACKGROUND
  Small cell carcinoma (SCC) of the renal pelvis and/or ureter is very rare, with only case reports published in the literature.
  
  
  OBJECTIVE
  To describe the clinicopathologic and immunohistochemical findings in the largest series to date.
  
  
  METHODS
  A review of a regional cancer registry identified 10 cases diagnosed as SCC from 930 patients with renal pelvic and/or ureteral cancer from 1971 to 1998. The original slides, demographics, treatment, and clinical outcome were reviewed. Representative sections were immunostained for AE1/AE3, cytokeratin 7, cytokeratin 20, CD56, synaptophysin, chromogranin, and thyroid transcription factor 1.
  
  
  RESULTS
  Of the 10 cases, 5 were pure SCC, 2 were mixed (SCC and urothelial carcinoma), 2 were reclassified as poorly differentiated squamous carcinoma, and 1 was reclassified as urothelial carcinoma. The patients with SCC had an age range of 50 to 80 years (median, 72 years) with a female to male ratio of 2.5:1. All patients had non-organ confined disease. Five of 7 patients died of disease; 4 of those 5 had been clinically followed (median survival, 23 months) and 1 was diagnosed at autopsy. The SCC cases revealed positive staining of the SCC component as follows: AE1/AE3 (7 of 7), CD56 (7 of 7), synaptophysin (6 of 7), thyroid transcription factor 1 (5 of 7), chromogranin (4 of 7), and cytokeratin 7 (1 of 7). None were positive for cytokeratin 20 (0 of 7).
  
  
  CONCLUSIONS
  SCC of the renal pelvis/ureter is seen in a predominately female population in Sweden, is clinically aggressive, and has poor survival when presenting at an advanced stage in patients only treated by surgery. An immunostain panel serves as a useful adjunct in classifying these tumors.
authors: Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, 68198-3135, USA.
authors: Ross J
authors: RJ
authors: Miller
authors: Sten
authors: S
authors: Holmäng
authors: Sonny L
authors: SL
authors: Johansson
authors: Subodh M
authors: SM
authors: Lele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000378:metabolism* / Q000473:pathology*; D002864:Chromogranins / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D013548:Sweden; D016708:Synaptophysin; D014516:Ureteral Neoplasms / Q000378:metabolism* / Q000473:pathology*; D033921:Vesicular Transport Proteins / Q000378:metabolism
chemical_list: D002864:Chromogranins; C569014:SYP protein, human; D016708:Synaptophysin; D033921:Vesicular Transport Proteins; D007633:Keratins