title: Primary metastatic neuroendocrine small cell bladder cancer: a case report and literature review.
abstract: Small cell carcinoma of the urinary bladder (SCCUB) is a rare variant of neuroendocrine nonepithelial tumor. Clinically, SCCUB appears like a flat or ulcerated lesion and microscopically can cause microvascular invasion and necrosis. Small cell cancer, rarely found in the urogenital tract in a primitive form, usually coexists with urothelial bladder cancers. It has an incidence of 0.35-0.7% of all bladder neoplasms and survival at 5 years is estimated to be around 8%. A 60-year-old man who was a smoker was referred to our department with episodes of gross hematuria and pain in the lumbar region. After an extensive transurethral resection of the bladder, including of the muscular layer, the diagnosis of small cell carcinoma of the bladder was made. The neoplastic cells were positive with immunohistochemical staining for chromogranin A, paranuclear reactivity to cytokeratin and neuron-specific enolase. A total-body CT scan revealed lymph node involvement and hepatic, adrenal and lung metastases. Because of the advanced stage it was decided to avoid radical cystectomy and perform chemotherapy. The patient underwent two different cycles of cisplatin chemotherapy following international recommendations, but unfortunately without any response. After palliative therapy, the patient died in January 2010.
authors.affiliation: Department of Urology, Sapienza Rome University, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cerulli
authors.forename: G M
authors.initials: GM
authors.lastname: Busetto
authors.forename: G
authors.initials: G
authors.lastname: Antonini
authors.forename: R
authors.initials: R
authors.lastname: Giovannone
authors.forename: M
authors.initials: M
authors.lastname: Di Placido
authors.forename: G
authors.initials: G
authors.lastname: Soda
authors.forename: E
authors.initials: E
authors.lastname: De Berardinis
authors.forename: V
authors.initials: V
authors.lastname: Gentile
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry / Q000188:drug therapy / Q000556:secondary*; D018288:Carcinoma, Small Cell / Q000737:chemistry / Q000188:drug therapy / Q000556:secondary*; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D055752:Small Cell Lung Carcinoma / Q000556:secondary; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D051598:Whole Body Imaging
chemical_list: D014408:Biomarkers, Tumor