Neoadjuvant Chemotherapy in Neuroendocrine Bladder Cancer: A Case Report

Abstract

Patient: Male, 71Final Diagnosis: Neuroendocrine cancer bladderSymptoms: Dysuria • haematuriaMedication: —Clinical Procedure: Transurethral resection of the bladder tumorSpecialty: OncologyObjective:Rare diseaseBackground:Small cell carcinoma of the urinary bladder is a rare and aggressive form of bladder cancer that mainly presents at an advanced stage. As a result of its rarity, it has been described in many case reports and reviews but few retrospective and prospective trials, showing there is no standard therapeutic approach. In the literature the best therapeutic strategy for limited disease is the multimodality treatment and most authors have extrapolated treatment algorithms from the therapy recommendations of small cell lung cancer.Case Report:A 71-year-old male patient was referred to our hospital with gross hematuria and dysuria. Imaging and cystoscopy revealed a vegetative lesion of the bladder wall. A transurethral resection of the bladder was performed. Pathological examination revealed a pT2 high-grade urothelial carcinoma with widespread neuroendocrine differentiation. Multimodal treatment with neoadjuvant platinum-based chemotherapy was performed. A CT scan performed after chemotherapy demonstrated a radiological complete response. The patient underwent radical cystectomy and lymphadenectomy. The histopathological finding of bladder and node specimen confirmed a pathological complete response. A post-surgery CT scan showed no evidence of local or systemic disease. Six months after surgery, the patient is still alive and disease-free.Conclusions:A standard treatment strategy of small cell cancer of the urinary bladder is not yet well established, but a multimodal treatment of this disease is the best option compared to surgical therapy alone. The authors confirm the use of neoadjuvant chemotherapy in limited disease of small cell carcinoma of the urinary bladder.

Giant bladder stone with squamous cell carcinoma of bladder: Case report and the literature review

“…Based on available literature [ 3 , 8 , [14] , [15] , [16] , [17] , [18] , [19] , [20] ], three case reports state a mass in the urinary bladder with bladder stone has the biopsy with the squamous cell carcinoma [ 3 , 8 , 16 ], while others reported translational cell carcinoma, urothelial carcinoma, hemangioma, and villous adenoma. By diameter, the stones found in our patient's bladder are perhaps the largest which ever reported being associated with bladder SCC.…”

“… KUB: large, lamellated radiopaque shadow at the pelvis; VCUG revealed left reflux grade IV; Cystoscopy: stone with underlying multiple erythematous bladder wall; Radical cystectomy + ileal conduit urinary diversion was conducted Kirakoya et al [ 3 ] 2018 60 M Dysuria; haematuria; nocturia, intermittent suprapubic pain; a hard well-defined suprapubic mass; digital rectal examination: a hard and painless mass Pyuria; plain abdominal x-ray: opacity occupying the entire pelvic. Whitish weighed 1.1 kg with 13 cm × 10 cm Yes Muscle invasive squamous cell carcinoma (SCC) NA NA lost to follow up for 18 months; recurrent haematuria; died from severe anaemi Cystolithotomy The patient refuses radical cystectomy Prelaj et al [ 17 ] 2016 71 M Dysuria; haematuria, Cystectomy + lymphadenectomy + placement of bilateral ureterocutaneostomy; No Yes pT2 high-grade urothelial carcinoma Yes NA Underwent neoadjuvant chemotherapy On the left lateral, the anterior wall was found bladder vegetative lesion with size of 34 × 24 mm Syu, Syuan-hao et al [ 18 ] 2018 17 F persistent gross hematuria Partial resection of TURBT showed chronic inflammation; 3.6 cm mass on supero-anterior wall of bladder No Yes Cavernous hemangioma NA NA Showed no local recurrence in 2 years (6, 12, and 24 months follow up) on Cystoscopy and CT Morozumi et al [ 19 ] 2017 ...…”

A Rare but Real Entity: Bladder Neuroendocrine Cancer

“…Whether used alone or as part of a multimodal regimen, from cytostatics cisplatin (or possibly carboplatin) and etoposide, ifosfamide-doxorubicin, cisplatin (or carboplatin) and irinotecan are recommended, and in mixed tumours, methotrexate, vincristine, cyclophosphamide and taxanes may be added. The poor general condition of the patient sometimes only allows monotherapy [5,8,11,13,16,17,21,[25][26][27][28][29].…”

The Colorful Palette of Neuroendocrine Neoplasms in the Genitourinary Tract

“…Early diagnosis of the disease as well as surgery, neoadjuvant, adjuvant, or palliative chemotherapy with or without radiotherapy are the cornerstones of patient care (13,(48)(49)(50). Details about prognosis and therapy are shown in Table III (13,23,35,41,42,44,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60).…”