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SMALL CELL NEUROENDOCRINE CARCINOMA OF THE BLADDER: REPORT OF FOUR CASES AND A REVIEW OF THE LITERATURE

Imane Bourhafour, Sanaa Elmajjaoui, Hanane Elkacemi, Tayeb Kebdani, Noureddine Benjaafar, Mila Kayryakova, Ivan Inkov.

Abstract
Purpose: Small cell neuroendocrine bladder carcinoma is a rare entity, account for less than 1% of all bladder tumors. They are of particular histological entity characterized by an aggressive clinical behaviour, high potential for metastatic spread and poor prognosis. The aim of this study was to describe the epidemiological, clinical, therapeutic modalities and the evolution data of small cell neuroendocrine bladder carcinomas.
Patients and methods: During a period of 10 years, four patients with neuroendocrine bladder carcinoma were treated at the National Institute of Oncology in Rabat.
Results: The median age was 66 years. There were three men and a woman. Neuroendocrine carcinoma was pure in one case and associated with transitional cell carcinoma in the other three cases. Two patients were diagnosed with lymph nodes involvement and one patient at a metastatic stage. A cystectomy was performed in one case. Two patients received a concurrent chemoradiation and the fourth patient received chemotherapy alone. A single case of complete remission was observed. Median survival was 18 months (630 months). Only one patient is still alive 30 months after diagnosis.
Conclusion: The management of neuroendocrine carcinoma of the bladder remains debated and vary from institution to author. Despite multimodality regimens, the prognosis of these tumours remains poor.

Key words: Small cell carcinoma, bladder, diagnosis, radiotherapy, chemotherapy, surgery


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