A rare bladder cancer - small cell carcinoma: review and update

Abstract

Small cell carcinoma of the bladder (SCCB) is rare, highly aggressive and diagnosed mainly at advanced stages. Hematuria is the main symptom of this malignancy. The origin of the disease is unknown; however the multipotent stem cell theory applies best to this case. Histology and immunohistochemistry shows a tumour which is indistinguishable from small cell lung carcinoma (SCLC). Coexistence of SCCB with other types of carcinoma is common. The staging system used is the TNM-staging of bladder transitional cell carcinoma. The treatment is extrapolated from that of SCLC. However, many patients with SCCB undergo radical resection which is rarely performed in SCLC. Patients with surgically resectable disease (< or = cT1-4aN0M0) should be managed with multimodal therapy associating chemotherapy, surgery and/or radiotherapy. Neoadjuvant chemotherapy using four chemotherapy cycles followed by radical cystectomy is the most effective therapeutic sequence. Patients with unresectable disease (> or = cT4bN+M+) should be managed with palliative chemotherapy based on neuroendocrine type regimens comprising a platinum drug (cisplatin in fit patients). The prognosis of the disease is poor mainly in the case of pure small cell carcinoma. Other research programs are needed to improve the outcome of SCCB.

Yedi olguda mesanenin nöroendokrin tümörlerinin değerlendirilmesi

“…Pulmoner kökenli nöroendokrin tümörlere göre daha nadir de olsa hiperkalsemi, Cushing Sendromu veya duyusal nöropati gibi paraneoplastik sendromlarla da karşımıza çıkabilmektedir 4 . Erkeklerde kadınlara göre daha sık görülmekte olup en sık görüldüğü yaş 6-7. dekatlardır 5 Mesanenin konvansiyonel ürotelial karsinomuyla benzer olarak, bu tümörlerde de belirgin bir erkek cinsiyet baskınlığı vardır ve en sık 6.-7. dekatlarda görülür 9 . Serimizde E:K oranı 5:2, olup, yaş ortalaması 66,8 yıldır (55-82 yıl).…”

Small-Cell Carcinoma of the Genitourinary Tract: A Point of View

“…Outcomes are poorer in gu scc than in the usual histologic types. Current knowledge about these tumours is limited and is based mainly on retrospective investigations and a few prospective studies [2][3][4][5][6] .…”

“…However, we do not agree that the treatment should be analogous to that used in the treatment of small-cell lung cancer. Rather, therapy should be guided by the anatomic site of the disease [2][3][4][5][6][7][8] .…”

“…In a large retrospective comparative study, the same group showed that, compared with surgery alone, neoadjuvant chemotherapy is highly effective (59.5 months vs. 18.3 months, p < 0.001) 10 . In advanced disease, platinum-based chemotherapy (cisplatin for fit patients) is the only treatment 2,3,8 . Prophylactic cranial irradiation should be considered in stage iii or iv scc of the bladder 2,9 .…”

“…In advanced disease, platinum-based chemotherapy (cisplatin for fit patients) is the only treatment 2,3,8 . Prophylactic cranial irradiation should be considered in stage iii or iv scc of the bladder 2,9 .…”