Small Cell Carcinoma of the Ovary Presenting in a Urine Cytology Specimen: A Case Report

Abstract

Background: Small cell carcinoma (SMCC) is rarely diagnosed in urine specimens. Cytologically, this tumor is similar to pulmonary SMCC. However, clinicopathologic correlation may be required to differentiate between primary urinary bladder SMCC and metastatic SMCC from a remote primary or secondary bladder involvement by direct extension of the tumor from nearby organs (prostate, uterus, or ovary). A unique case of a rare pulmonary-type ovarian SMCC, the tumor cells of which were detected in a voided urine specimen, is described herein. Case: A 79-year-old female presented to the urologic clinic with a history of metastatic SMCC of unknown primary with hematuria. The voided urine specimen examination revealed tumor cells cytomorphologically consistent with small cell neuroendocrine carcinoma. Following cytologic diagnosis, cystoscopic examination and bladder biopsy were performed. The histopathology revealed a widely invasive tumor with a morphology typical of SMCC. The overlying urothelium was unremarkable. By immunohistochemistry, tumor cells were found positive for neuroendocrine markers, EMA and WT-1. The morphologic and immunohistochemical features of the tumor were most consistent with urinary bladder involvement by pulmonary-type primary ovarian SMCC. Conclusion: It is justified to think that SMCC cell detection in urine specimens does not necessarily imply their origin from primary bladder malignancy. Performing additional studies may be prudent in order to exclude secondary involvement of the bladder in this tumor as the correct diagnosis has significant clinical implications.

Cytologic diagnosis of small cell carcinoma of the ovary: A case report with review of the literature

“…Furthermore, in the present report, cytomorphologic features of SCCOPT metastatic to cervix, on Papanicolaou stained, SurePath preparation have also been highlighted. There are only occasional case reports wherein cytological features of SCCO have been presented, mainly of the hypercalcemic type; with only a few diagnosed primarily on exfoliative cytology . We believe ours is the first report of a SCCOPT being diagnosed by FNAC, supplemented with ICC on cell‐block.…”

“…There are only occasional case reports wherein cytological features of SCCO have been presented, mainly of the hypercalcemic type; [16][17][18][19][20] with only a few diagnosed primarily on exfoliative cytology. 21,22 We believe ours is the first report of a SCCOPT being diagnosed by FNAC, supplemented with ICC on cellblock.…”

Microfilaria in urine cytology: Report of three cases with review of literature

“…Although other primary tumors of bladder, namely small cell carcinoma, melanoma and Hodgkin lymphoma have been diagnosed on urine cytology, coexistent filarial infestation has not been reported in any of them 23‐25 . Few metastatic tumors like signet ring cell carcinoma of stomach, small cell carcinoma of ovary, lobular carcinoma of breast and metastatic melanoma have also been described in urine sediment 26‐29 . However, presence of filarial worm with a concomitant metastatic carcinoma in urine cytology is extremely rare with a single case report of metastatic melanoma of bladder 21 .…”

Urine cytology of nonurothelial malignancies—a 10‐year experience in a large multihospital healthcare system

“…Primary nonurothelial tumors are composed of squamous, glandular, neuroendocrine, melanocytic, mesenchymal, hematopoietic, and lymphoid tumors. 4 Secondary tumors to the bladder can result due to direct extension from adjacent organs or by lymphatic or hematogenous spread from distant organs. 1,3 Primary small cell carcinoma comprises <2% of bladder tumors.…”

“…1,3 Primary small cell carcinoma comprises <2% of bladder tumors. 4 Secondary tumors to the bladder can result due to direct extension from adjacent organs or by lymphatic or hematogenous spread from distant organs.…”