Objective To investigate the clinical and pathological characteristics of small cell carcinoma of the bladder.
Methods The basic data of 9 cases of small cell carcinoma of the bladder were retrospectively analyzed. Six cases were male and three cases were female. The age ranged from 45 to 79 years old, with an average of 62 years old. The clinical manifestations were carnal hematuria in 7 cases, difficulty in urination and lower abdominal pain in 2 cases. The tumor diameter ranged from 0.5 to 7.0 cm, with an average of 2.0 cm; 2 cases were multiple, 5 cases were solitary, and 2 cases had diffuse growth of the whole bladder. 7 cases had urinary exfoliation cytology, and 4 cases were positive. 1 case showed high blood calcium (3.15 mmol/L) and low blood phosphorus (0.61 mmol/L) in the preoperative examination, and normalized 1 month after surgery. 9 cases were treated surgically, and 4 of them were diagnosed as All 9 cases were treated surgically, of which 4 cases were diagnosed superficially with TUR-BT, and all of them were treated with regular pyrrolizidine bladder perfusion and 1 case with 3 cycles of chemotherapy after surgery; 2 cases were treated with partial bladder resection, all of them were treated with regular pyrrolizidine bladder perfusion and 1 case with 2 cycles of chemotherapy; 3 cases were treated with total radical bladder resection and 2 cases were treated with intravenous chemotherapy.
Postoperative pathological examination: the tumor cells were small in size, round in shape, with sparse cytoplasm, densely stained nuclei and lacking nest-like structures. Immunohistochemical staining: CgA(+), neuron-specific enolase(+). The diagnosis was small cell carcinoma, including one case containing a migratory cell carcinoma component and one case with combined prostate cancer. Four cases with preserved bladder were followed up, and three died of metastasis at 4, 9, and 25 months after surgery, respectively, and one case with postoperative chemotherapy was followed up for 24 months without recurrence or metastasis. Two of the three cases with total bladder resection died at 2 and 28 months postoperatively, respectively, and one case had no tumor recurrence or metastasis at 32 months postoperative follow-up.
It is concluded that small cell carcinoma of the bladder has high malignancy and poor prognosis, radical total cystectomy + systemic chemotherapy is the main treatment method, and surgery to preserve the bladder should be combined with systemic chemotherapy, the prognosis is determined by the clinical stage of the tumor and the choice of treatment.