Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report

Abstract

Background Neuroendocrine carcinomas of the urinary bladder are rare tumors, estimated at less than 1% of urinary bladder malignancies. They are mainly represented by small cell neuroendocrine carcinoma, while large cell neuroendocrine carcinoma (LCNEC) is rarely reported. Case presentation We report a case of a 49-year-old man presenting paraplegia caused by a metastatic urinary bladder LCNEC, which was managed with palliative external beam radiotherapy (EBRT) associated with MVAC chemotherapy, including methotrexate, vinblastine sulfate, doxorubicin hydrochloride (Adriamycin), and cisplatin. At the last follow-up of one year after his admission, there was a symptomatic improvement in the pain intensity. Conclusion LCNEC of the bladder was first described in 1986, and, until now, less than 40 cases have been published in the literature. To the best of our knowledge, this is the first case of primary LCNEC of the urinary bladder presenting with paraplegia.

A Case of Bladder Large Cell Carcinoma with Review of the Literature

“…Thirty-seven original reports or case series were identified [3, 7-42], accounting for 122 patients, spanning from 1986 to 2021. We then included our case, for a total of 123 patients.…”

“…Of them, 39% (26/67) were alive at their respective data cutoffs. Among those with metastatic disease at diagnosis, only 1 (5%) was reported to be alive [42], versus 24 (52%) of the nonmetastatic patients ( p = 0.0001). In the latter group, 83% with T1-2 stage were alive, as compared to 38% with T3-4 disease ( p = 0.02).…”

Primary pure large cell neuroendocrine carcinoma of the urinary bladder: a case report and literature review

“…The manifestation of gross hematuria accompanied by lower urinary tract irritation constitutes a characteristic symptom ( 49 ), characterized at the cellular level by insufficient differentiation and profound invasiveness. As a result of the absence of characteristic clinical symptoms during the initial phases of the illness, delayed diagnosis is common, resulting in a high occurrence of metastases and a poor prognosis ( 42 ). Out of the previously described instances of LCNEC of the urinary bladder, 65% of cases had a pathological staging of T3 or T4 (the tumor has infiltrated the serosal layer) ( 50 ), possibly owing to the absence of a discernible correlation between early lesions and the manifestation of typical hematuria symptoms.…”