Neuroendocrine urinary bladder tumor – as a contribution to the extending of knowledge on the urothelium

Abstract

Introduction: The structure of bladder epithelium is a very complex. Apart of main structural cells of the epithelium, there are scattered neuro-endocraine cells that form a specific system, which was called the diffuse neuroendocrine system (DNS). Facts about the DNS of the bladder epithelium is still blowing. Diffuse neuroendocrine system cell cells can undergo cancerous transformation and form a very heterogeneous group of cancers referred to neuroendocrine cancers. Urinary neuroendocrine tumors are very especially rare and location them in the urinary bladder belongs to exceptional rarity. Only a few cases can be found in world literature, therefore we decided to present our case to extend global knowledge. 
Matherials and methods: To Department of Urology 109 Military Hospital was admitted 49-year-old male with gross haematuria. The ultrasound examination revealed a presence of tumor on the left wall of the bladder urinary. The preliminary 
diagnostic was enhanced – by CT scan. It confirmed the bladder urinary tumor without an evidence of distant metastasis. The histopathologic examination showed a pattern of high grade neuroendocrine carcinoma in at least pT2 stage. The patient was referred for radical cystectomy. During an operation a large abscess of the left kidney was disclosed. The operation was extended to left nephrectomy. The postoperative time went smoothly. Primary neuroendocraine tumors of the urinary bladder are an exceptional entity with only about 30 cases reported in the literature. Due to its rarity, additional studies are necessary to better define the optimal therapeutic management. We decided to further monitor our patient and in the case of new circumstances to present him in subsequent reports. A review of literature and treatment strategies are discussed.