SMALL CELL CARCINOMA OF THE URINARY BLADDER

Introduction: Small cell carcinoma of the bladder is a rare entity characterized clinically by an aggressive behavior with a high incidence of systemic metastases. We report the clinicopathologic findings of five cases. Materials and Methods: We reviewed five consecutive patients with small cell carcinoma of the bladder treated at our clinic. In each case, the following clinical data were recorded: age, sex, presenting symptoms, endoscopically determined location of the tumor, clinical staging, treatment, follow-up and outcome. Results: There were four male and one female patients, age range 47 to 71 years, mean 57.6 years. The clinical presentation was not different from conventional transitional cell carcinoma, with hematuria being the most frequent complaint (four cases). Microscopic examination revealed oat cells in all cases. At the time of diagnosis, the tumors were staged as T3bN0M0 in three cases and T2N0M0 in two cases. Primary therapy consisted of radical cystectomy and chemotheraphy in all cases. Four patients died of progressive disease, with survival from the time of diagnosis ranging from seven to 16 months (mean, 12.2 months). Conclusion: Our study shows that primary small cell carcinoma of the urinary bladder is as aggressive as its pulmonary counterpart and the overall prognosis of this tumor is very poor. The management that seems to give a better survival is the combination of radical cystectomy and chemotherapy.