Clinicopathologic Observation of 6 Cases with Neuroendocrine Carcinoma of the Urinary Bladder

Abstract

OBJECTIVE To discuss the pathologic characteristics and the prognosis of neuroendocrine carcinoma of the bladder (NECB) in order to assist in making a precise diagnosis and to effectively treat the disease. METHODS Clinicopathologic features of the 6 cases with NECB were analyzed retrospectively. The personal data of the patients and the pathologic and immunohistochemical characteristics of the tumor were investigated. The follow-up of these patients was conducted over a time period ranging from 3 months to 9 years. RESULTS Transurethral resection of the bladder tumor was performed in all 6 patients. Based on the results of the pathologic examination, 4 of the cases were diagnosed as small cell neuroendocrine carcinoma and the other 2 were diagnosed as atypical carcinoid tumor. On immunohistochemical staining all tumors expressed neuroendocrine markers including neuronspecific enolase (CD56), synaptophysin (Syn) and chromogranin (CgA). In patients receiving partial cystectomy followed by postoperative chemotherapy, relapse was found in 4 of the 6 cases on follow up. CONCLUSION NECB is a rare entity and a tumor with high malignant potential and characteristic pathologic features. Hematuria is the cardinal symptom of NECB. Metastasis may occur at an early stage and the prognosis of the disease is poor. Final diagnosis of NECB depends on histopathologic examination and immunohistochemical assays. Surgical excision combined with radiotherapy and chemotherapy is considered an effective treatment.

Keywords

• bladder neoplasms
• carcinoma
• neuroendocrine
• pathologic diagnosis.