| CASE REPORT |
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| Year : 2022 | Volume
: 2
| Issue : 2 | Page : 104-106 |
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High-grade carcinoma with neuroendocrine differentiation of the urinary bladder: A case report of a rare variant
Shashank Bansal, Prutha Jinwala, Aditya Elhence, SP Shrivastava, Vikas Asati, Rajesh Patidar, Prakash G Chitalkar
Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Correspondence Address:
Dr. Shashank Bansal
Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/aort.aort_20_22
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Neuroendocrine bladder carcinoma is considered a rare variant (<1%) with highly aggressive potential. Because of the rarity of its presentation, available data are mainly from published case reports. A 40-year-old male presented with painless hematuria for the past 3 months. After evaluation, he underwent radical cystectomy with pelvic lymph node dissection with urinary diversion. Histopathology from the postoperative specimen was suggestive of high-grade carcinoma with neuroendocrine differentiation (CK-focal positive, synaptophysin-focal positive, GATA-3, CD-56 positive and Ki-67 85%–90% chromogranin A-negative) stage pT4bN2M0. The case was discussed in the multidisciplinary tumor board and was planned for adjuvant chemotherapy with cisplatin (75 mg/m2) and etoposide (100 mg/m2) Repeated every 21 days. He completed six cycles of adjuvant chemotherapy and was on follow-up. Within 3 months of completing adjuvant therapy, he presented again with a complaint of hematuria and on evaluation found to have a localized recurrence, following which he received radical chemoradiotherapy and is now on follow-up. Our case provides evidence to think us in new dimension, with chemotherapy in adjuvant and radiation in salvage settings instead of adjuvant settings.
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