Primary large cell neuroendocrine carcinoma of the urinary bladder

Abstract

Primary large cell neuroendocrine carcinomas (LCNEC) of the urinary bladder are rare. Reported herein is a case of a primary, pure LCNEC occurring in a man. The patient was a 32-year-old man who presented with hematuria of 1 week's duration. On cystoscopic examination, a solitary mass measuring 3 cm in diameter was detected protruding from the anterosuperior wall of the urinary bladder. Two months after the primary transurethral resection, significant regrowth of the remnant mass was noted on CT, and the patient underwent a partial cystectomy. A diagnosis of LCNEC was made based upon histological and immunohistochemical findings. Tumor cells were positive for synaptophysin, chromogranin A, CD56, epithelial membrane antigen, and cytokeratin. Histologically, the tumor penetrated the deep muscle and perivesical fat. In spite of three cycles of chemotherapy, the patient developed multiple metastases in the lung and liver 10 months postoperatively. LCNEC of the urinary bladder are uncommon entities, which have a possible fatal outcome.

Urinary Cytologic Features of Primary Large Cell Neuroendocrine Carcinoma of the Urinary Bladder

“…The most widely accepted view of the histogenesis seems that large cell neuroendocrine carcinoma of the bladder originates in a pluripotential stem cell that can differentiate into various cell types. [1][2][3]5,7 It is interesting to note that the urothelial carcinoma and large cell neuroendocrine carcinoma in the current case were entirely independent in terms of time of occurrence, localization, morphology and immunoprofile. Table I summarizes 14 reported cases of large cell neuroendocrine carcinoma of the bladder in the literature and the current case.…”

“…Of these, 11 were stage III or IV, resulting in poor prognoses despite cystectomy, chemotherapy or radiotherapy. 1,2,4,[7][8][9] The only long-term survivors were patients in whom the tumor was organ confined and successfully removed by cystectomy. To establish effective therapeutic strategies, earlier detection of this tumor will be the issue of greatest concern.…”

Large Cell Neuroendocrine Carcinoma of the Urinary Bladder: Case Report and Review

“…Lee et al [10] report a case of LCCB in a 32-year-old man treated with partial cystectomy and adjuvant chemotherapy. Metastasis at lung and liver was present 12 months after the diagnosis.…”

“…Primary SCCB is a rare disease that accounts for less than 0.7% of all bladder cancers [29,30]. Primary LCCB is an even rarer disease first described in 1986 [4] and with 17 more cases reported since then [5,6,7,8,9,10,11,12,13,14,15,16]. …”

“…Large cell carcinoma of the urinary bladder (LCCB) was first reported in 1986 [4] and since then 17 more cases have been described on the literature [5,6,7,8,9,10,11,12,13,14,15,16]. Because of the relative rarity of these tumors there is no standard approach for managing SCCB [17] or LCCB [13].…”