Small Cell Neuroendocrine Carcinoma of the Urinary Bladder with Admixed Squamous Differentiation: A Case Report
DOI:
https://doi.org/10.21276/apalm.3908Keywords:
urinary bladder, small cell neuroendocrine carcinoma, squamous differentiation, scnec, turbtAbstract
Introduction: Small cell neuroendocrine carcinoma (SCNEC) of the urinary bladder is a rare and highly aggressive malignancy, accounting for less than 1% of bladder tumors. The presence of mixed histological components such as squamous differentiation poses diagnostic challenges, particularly in limited biopsy specimens.
Case Presentation: We report a case of a 75-year-old male presenting with painless hematuria. Imaging revealed asymmetric thickening of the urinary bladder wall involving the left lateral and posterior wall. Transurethral resection of bladder tumor (TURBT) was performed. Histopathological examination showed a malignant neoplasm predominantly composed of small cell neuroendocrine carcinoma with an admixed squamous component. Immunohistochemistry demonstrated diffuse CD56 positivity, focal chromogranin expression, high Ki-67 proliferation index, and focal cytokeratin and p40 positivity in squamoid areas. The tumor infiltrated the muscularis propria.
Conclusion: Recognition of mixed histology in bladder SCNEC is crucial for accurate diagnosis and appropriate management. Immunohistochemistry plays a key role in distinguishing tumor components and avoiding diagnostic pitfalls.
References
1. Wang G, Xiao L, Zhang M, Kamat AM, Siefker-Radtke A, Dinney CP, et al. Small cell carcinoma of the urinary bladder: a clinicopathological and immunohistochemical analysis of 81 cases. Hum Pathol. 2018;79:57-65.
2. Raspollini MR, Compérat EM, Lopez-Beltran A, Montironi R, Cimadamore A, Tsuzuki T, et al. News in the classification of WHO 2022 bladder tumours. Pathologica. 2023;115(1):32-40.
3. Mohanty SK, Cheng L. The 2022 revision of the WHO classification of tumours of the urinary system and male genital organs. Hum Pathol. 2023;136:123-43.
4. Wang G, Yuan R, Zhou C, Guo C, Villamil C, Hayes M, et al. Urinary Large Cell Neuroendocrine Carcinoma: A Clinicopathologic Analysis of 22 Cases. Am J Surg Pathol. 2021;45(10):1399-1408.
5. Mollica V, Massari F, Andrini E, Rosellini M, Marchetti A, Nuvola G, et al. Prognostic factors of survival for highgrade neuroendocrine neoplasia of the bladder. Curr Oncol. 2022;29(8):5846-54.
6. Parimi V, Choi W, Feng M, Fong M, Hoffman-Censits J, Kates M, et al. Comparison of clinicopathological characteristics and outcomes of pure and mixed small-cell carcinoma of the bladder. Histopathology. 2023;82(7):991-1002.
7. Akbulut D, Al-Ahmadie H. Updates on urinary bladder tumours with neuroendocrine features. Adv Anat Pathol. 2024;31(3):169-77.
8. Alhalabi O, Wilson N, Xiao L, Lin Y, Khandelwal J, Moussa MJ, et al. Comparative effectiveness of treatment strategies for neuroendocrine carcinoma of the urinary tract. Eur Urol Oncol. 2023;6(6):611-20.
9. Myers AA, Fang AM, Moussa MJ, Hwang H, Wilson NR, Campbell MT, et al. Impact of systemic therapy on smallcell neuroendocrine carcinoma of the bladder. ESMO Open. 2024;9:103964.
10. Lu J, Zhou J, Liu Y, Li Y, Tang Y, Li N, et al. Treatment and survival of non-metastatic small cell carcinoma of the bladder. Sci Rep. 2024;14:24652.
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Copyright (c) 2026 Veena Gupta, Kritika Lohumi, Ankita Garg, Vibhuti Thukral, Prerna Bansal, Sunita Singh

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