Large-cell neuroendocrine carcinoma of the bladder: A case report

Large-cell neuroendocrine carcinoma of the bladder: A case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Large-cell neuroendocrine carcinoma of the bladder: A case report Yu Zhou, Lin Yang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4693740/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness. The bladder is characterized by four distinct forms of neuroendocrine tumors. Among them, large-cell neuroendocrine carcinoma is the least prevalent but has the highest level of aggressiveness. To date, only a few dozen cases have been reported. CASE SUMMARY Here, we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder. The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology. During hospitalization, abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder. A cystoscopic nonradical resection of the bladder lesion was performed. The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer. Large-cell neuroendocrine carcinoma of the bladder Treatment Prognosis Case report Figures Figure 1 Figure 2 CASE PRESENTATION Chief complaints A 65-year-old man presented to to the Urology Clinic with a 3-month duration of painless haematuria without any identifiable etiology. History of present illness The 65-year-old man had experienced macroscopic hematuria without obvious cause for three months. The blood was bright red in color without blood clots. The hematuria had occurred several times during the course of the disease. He had no other symptoms. History of past illness The patient's medical history was devoid of any conditions. Personal and family history The patient had no risk factors other than a prolonged history of smoking and alcohol usage. The patient reported no family history of any disease or cancerous growth. Physical examination The physical examination showed that the kidneys were symmetrical with no bulging, no tenderness to percussion, no tenderness to bilateral costovertebral points, and no vascular murmurs. There was no bulge in the lower abdomen, no tenderness over the pubic bone, and no tympanic sound on percussion. The vital signs of the patient were recorded as follows: Body temperature of 36.7 ℃; arterial blood pressure of 133/92 mmHg; SpO2 level of 98%; pulse rate of 74 beats per minute; respiration rate of 18 breaths per minute. In general, the findings of the physical examination were within normal limits. Laboratory examinations Laboratory analyses revealed an absolute lymphocyte value of 1.0 × 10 9 /L, a neutrophil percentage of 77.0%, lymphocyte percentage of 16.1%, eosinophil percentage of 0.3%, albumin level of 39.1 g/L, urine erythrocyte level of 236.0/UL, urine leukocyte level of 69.0/UL, and a weakly positive result for tissue polypeptide antigen. The remainder of the laboratory test results were within normal limits. Imaging examinations Ultrasound showed atypical echoes in the bladder and a substantial blood supply. The results of the non-contrast computed tomography of the whole abdomen and contrast-enhanced computed tomography of the urinary system revealed the presence of an irregular mass on the right anterior wall of the bladder (Figure 1). The mass had a size of approximately 30 mm × 29 mm and was observed to project into the lumen. Additionally, the lesion exhibited multiple speckles of hyperdense shadows, which became more pronounced after enhancement. Incisional biopsy A histological investigation conducted after the surgery demonstrated the presence of big cell neuroendocrine bladder cancer (Figure 2), characterized by the invasion of the muscular layer of the mucosa. The immunohistochemistry and histology results indicated the presence of SMA (+), GATA3 (+), HER-2 (+), CD56 (+), SYN (+), CGA (+), INSM1 (+), P53 (+), and Ki67 (+, 60%). FINAL DIAGNOSIS Based on the patient's history, laboratory test results, imaging, and histopathology, he was diagnosed with large-cell neuroendocrine carcinoma of the bladder. TREATMENT We first performed cystoscopic non-radical resection of the bladder lesion, and the chemotherapy regimen of etoposide + cisplatin was used after clarification based on postoperative pathological and immunohistochemical results. As the patient had undergone diagnostic resection with limited surgical scope without lymph node dissection, and considering the high rate of local recurrence of the tumor, separate cyst infusion chemotherapy was used. OUTCOME AND FOLLOW-UP The patient received a thoracic and abdominal non-contrast computed tomography 10 days post-surgery. The results revealed the presence of scattered nodules in both lungs, which were classified as low-risk nodules. No apparent abnormalities were observed. Due to the specific pathological type of the bladder tumor, the patient was transferred to the Oncology Department for follow-up chemotherapy. After discharge, the patient received regular chemotherapy and follow-up. No obvious metastasis or recurrence was found during the 7-month follow-up after surgery. DISCUSSION Neuroendocrine (NE) tumors of the bladder are rare [ 1 ] , accounting for < 1% of bladder malignancies. The majority of NE tumors of the bladder are small-cell neuroendocrine carcinomas (SCNECs). Large-cell neuroendocrine carcinoma (LCNEC) is much rarer, difficult to diagnose, prone to distant metastasis, a significantly low survival rate [ 2 ] , and a scarcity of related research data. The biological and clinicopathological characteristics of bladder LCNEC are mostly based on a limited number of research and case reports, owing to its rarity. LCNEC is still characterized by a multitude of uncertainties, hence constraining the progress and assessment of its treatment protocols. Currently, there is a lack of widely acknowledged agreement or standard for the management of LCNEC in academic settings. Nevertheless, the effectiveness of multimodal therapy has been demonstrated [ 3 , 4 – 6 , 7 ] . The current chemotherapy regimens for LCNEC are based on the treatment experience of lung NE [ 7 , 8 ] . Regarding prognosis, it is apparent that the survival of patients is consistently linked only to tumor-node-metastasis staging [ 9 ] . The cancer infiltrated the muscularis propria at stage T2 in this case. At seven months postoperatively, there was no notable recurrence or tumor spread, indicating a favorable prognosis. This finding provides evidence for the efficacy of our diagnostic and treatment regimens in the context of this particular patient. Currently, there is a lack of a universally accepted follow-up practice for individuals diagnosed with LCNEC. CONCLUSION In summary, bladder LCNEC is an uncommon malignant neoplasm with a highly unfavorable prognosis. Although there are ongoing efforts to enhance patient survival through multidisciplinary therapy, the prognosis remains unfavorable. LCNEC continues to be a subject of uncertainty [ 10 ] . Declarations Author contributions: Zhou Y was responsible for the data collection and manuscript composition; Yang L played a pivotal role in critically revising the manuscript for important intellectual content, ensuring the accuracy and integrity of the work; All authors have read and approved the final manuscript. Data Availability Statement ： All data supporting the findings of this study can be found in the manuscript. Ethics statement ： This study has been approved by the Ethics Committee of Bishan Hospital Affiliated to Chongqing Medical University and is conducted in accordance with relevant guidelines and regulations Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images. Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose. CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016). References Olivieri V , Fortunati V, Bellei L, Massarelli M, Ruggiero G, Abate D, Serra N, Griffa D, Forte F, Corongiu E. Primary small-cell neuroendocrine carcinoma of the bladder: Case report and literature review. Arch Ital Urol Androl 2020; 92 [PMID: 33016048 DOI: 10.4081/aiua.2020.3.211] Halabi R , Abdessater M, Boustany J, Kanbar A, Akl H, El Khoury J, El Hachem C, El Khoury R. Large Cell Neuroendocrine Carcinoma of the Bladder with Adenocarcinomatous Component. Case Rep Urol 2020; 2020 : 8827646 [PMID: 33083089 DOI: 10.1155/2020/8827646] Lopedote P , Yosef A, Kozyreva O. A Case of Bladder Large Cell Carcinoma with Review of the Literature. Case Rep Oncol 2022; 15 : 326-337 [PMID: 35529284 DOI: 10.1159/000521607] Akdeniz E , Bakirtas M, Bolat MS, Akdeniz S, Özer I. Pure large cell neuroendocrine carcinoma of the bladder without urological symptoms. Pan Afr Med J 2018; 30 : 134 [PMID: 30374380 DOI: 10.11604/pamj.2018.30.134.13437] Niu Q , Lu Y, Xu S, Shi Q, Guo B, Guo Z, Huang T, Wu Y, Yu J. Clinicopathological characteristics and survival outcomes of bladder neuroendocrine carcinomas: a population-based study. Cancer Manag Res 2018; 10 : 4479-4489 [PMID: 30349380 DOI: 10.2147/CMAR.S175286] Quek ML , Nichols PW, Yamzon J, Daneshmand S, Miranda G, Cai J, Groshen S, Stein JP, Skinner DG. Radical cystectomy for primary neuroendocrine tumors of the bladder: the university of southern california experience. J Urol 2005; 174 : 93-96 [PMID: 15947585 DOI: 10.1097/01.ju.0000162085.20043.1f] Wang G , Yuan R, Zhou C, Guo C, Villamil C, Hayes M, Eigl BJ, Black P. Urinary Large Cell Neuroendocrine Carcinoma: A Clinicopathologic Analysis of 22 Cases. Am J Surg Pathol 2021; 45 : 1399-1408 [PMID: 34074810 DOI: 10.1097/PAS.0000000000001740] Sanguedolce F , Calò B, Chirico M, Tortorella S, Carrieri G, Cormio L. Urinary Tract Large Cell Neuroendocrine Carcinoma: Diagnostic, Prognostic and Therapeutic Issues. Anticancer Res 2020; 40 : 2439-2447 [PMID: 32366387 DOI: 10.21873/anticanres.14213] Alijo Serrano F , Sánchez-Mora N, Angel Arranz J, Hernández C, Alvarez-Fernández E. Large cell and small cell neuroendocrine bladder carcinoma: immunohistochemical and outcome study in a single institution. Am J Clin Pathol 2007; 128 : 733-739 [PMID: 17951193 DOI: 10.1309/HTREM6QYQDYGNWYA] Chong V , Zwi J, Hanning F, Lim R, Williams A, Cadwallader J. A case of large cell neuroendocrine carcinoma of the bladder with prolonged spontaneous remission. J Surg Case Rep 2017; 2017 : rjw179 [PMID: 28560016 DOI: 10.1093/jscr/rjw179] Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4693740","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":335704112,"identity":"637955d1-bce1-4a70-8cfb-aa26824c504c","order_by":0,"name":"Yu Zhou","email":"","orcid":"","institution":"Bishan Hospital Affiliated to Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yu","middleName":"","lastName":"Zhou","suffix":""},{"id":335704113,"identity":"b503f462-ae3b-43f3-a2a9-3eb16a748e26","order_by":1,"name":"Lin Yang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzElEQVRIiWNgGAWjYBACfvaGxIcf/9gwAxlEapHsOfDYWLIhjR3IIFKLwY3EZxK8DYf5DW4kEOuyM4eTDSR3MEtLzny88QZDjU00QR2M7W2JDwrPsBnzS6cVWzAcS8ttIKSFmedMsoEEG0+y5OwcMwnGhsOEtbBJ5H+T4GGTqN9w8wyRWngkEtIkeNsMmA1u8BCpRYLnQLKxxJkEZskeoF8SiPGL/XFgVH6o+A+MysMbb3yosSGsBRkYSCSQohyihVQdo2AUjIJRMDIAAKtlQSBnBT8VAAAAAElFTkSuQmCC","orcid":"","institution":"Bishan Hospital Affiliated to Chongqing Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Yang","suffix":""}],"badges":[],"createdAt":"2024-07-05 17:45:57","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4693740/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4693740/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62216229,"identity":"e2c53b9c-025b-45f2-8d35-3271c0ad3b70","added_by":"auto","created_at":"2024-08-11 11:41:52","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":165237,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComputed tomography scan. \u003c/strong\u003eA and B: Computed tomography (CT) scan of the whole abdomen. The presence of an irregular mass on the right anterior wall of the bladder. The mass had a size of approximately 30 mm × 29 mm and was observed to project into the lumen (orange arrow); C: Abdominal CT enhancement. The lesion exhibited multiple speckles of hyperdense shadows, which became more pronounced after enhancement (orange arrow).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4693740/v1/afa61fc6dc5c54250dcceb16.png"},{"id":62216228,"identity":"3268b9c4-48e4-499a-a627-9ff9dc7df6f1","added_by":"auto","created_at":"2024-08-11 11:41:52","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":703117,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eHistopathologic analysis of the resected specimen. \u003c/strong\u003eTumor with a large nest arrangement, showing peripheral fenestrations and rosette knots (orange arrow), together with abundant bright eosinophilic cytoplasm and apoptotic vesicles (black arrow).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4693740/v1/78489a0058a114d1111c7ba9.png"},{"id":64216569,"identity":"13d161e2-929b-4ccf-977d-9d3f167af4d1","added_by":"auto","created_at":"2024-09-10 09:49:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1275358,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4693740/v1/50b03486-47e5-4025-bff1-a4ae4eb583a2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Large-cell neuroendocrine carcinoma of the bladder: A case report","fulltext":[{"header":"CASE PRESENTATION","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eChief complaints\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA 65-year-old man presented to to the Urology Clinic with a 3-month duration of painless haematuria without any identifiable etiology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eHistory of present illness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 65-year-old man had experienced macroscopic hematuria without obvious cause for three months. The blood was bright red in color without blood clots. The hematuria had occurred several times during the course of the disease. He had no other symptoms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eHistory of past illness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient's medical history was devoid of any conditions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePersonal and family history\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient had no risk factors other than a prolonged history of smoking and alcohol usage. The patient reported no family history of any disease or cancerous growth.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePhysical examination\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe physical examination showed that the kidneys were symmetrical with no bulging, no tenderness to percussion, no tenderness to bilateral costovertebral points, and no vascular murmurs. There was no bulge in the lower abdomen, no tenderness over the pubic bone, and no tympanic sound on percussion. The vital signs of the patient were recorded as follows: Body temperature of 36.7\u0026nbsp;℃; arterial blood pressure of 133/92 mmHg; SpO2 level of 98%; pulse rate of 74 beats per minute; respiration rate of 18 breaths per minute. In general, the findings of the physical examination were within normal limits.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eLaboratory examinations\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLaboratory analyses revealed an absolute lymphocyte value of 1.0 × 10\u003csup\u003e9\u003c/sup\u003e/L, a neutrophil percentage of 77.0%, lymphocyte percentage of 16.1%, eosinophil percentage of 0.3%, albumin level of 39.1 g/L, urine erythrocyte level of 236.0/UL, urine leukocyte level of 69.0/UL, and a weakly positive result for tissue polypeptide antigen. The remainder of the laboratory test results were within normal limits.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eImaging examinations\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUltrasound showed atypical echoes in the bladder and a substantial blood supply. The results of the non-contrast computed tomography of the whole abdomen and contrast-enhanced computed tomography of the urinary system revealed the presence of an irregular mass on the right anterior wall of the bladder (Figure 1). The mass had a size of approximately 30 mm × 29 mm and was observed to project into the lumen. Additionally, the lesion exhibited multiple speckles of hyperdense shadows, which became more pronounced after enhancement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIncisional biopsy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA histological investigation conducted after the surgery demonstrated the presence of big cell neuroendocrine bladder cancer (Figure 2), characterized by the invasion of the muscular layer of the mucosa. The immunohistochemistry and histology results indicated the presence of SMA (+), GATA3 (+), HER-2 (+), CD56 (+), SYN (+), CGA (+), INSM1 (+), P53 (+), and Ki67 (+, 60%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eFINAL DIAGNOSIS\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the patient's history, laboratory test results, imaging, and histopathology, he was diagnosed with large-cell neuroendocrine carcinoma of the bladder.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTREATMENT\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe first performed cystoscopic non-radical resection of the bladder lesion, and the chemotherapy regimen of etoposide + cisplatin was used after clarification based on postoperative pathological and immunohistochemical results. As the patient had undergone diagnostic resection with limited surgical scope without lymph node dissection, and considering the high rate of local recurrence of the tumor, separate cyst infusion chemotherapy was used.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eOUTCOME AND FOLLOW-UP\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient received a thoracic and abdominal non-contrast computed tomography 10 days post-surgery. The results revealed the presence of scattered nodules in both lungs, which were classified as low-risk nodules. No apparent abnormalities were observed. Due to the specific pathological type of the bladder tumor, the patient was transferred to the Oncology Department for follow-up chemotherapy. After discharge, the patient received regular chemotherapy and follow-up. No obvious metastasis or recurrence was found during the 7-month follow-up after surgery.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eNeuroendocrine (NE) tumors of the bladder are rare\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e, accounting for \u0026lt;\u0026thinsp;1% of bladder malignancies. The majority of NE tumors of the bladder are small-cell neuroendocrine carcinomas (SCNECs). Large-cell neuroendocrine carcinoma (LCNEC) is much rarer, difficult to diagnose, prone to distant metastasis, a significantly low survival rate\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e, and a scarcity of related research data.\u003c/p\u003e \u003cp\u003eThe biological and clinicopathological characteristics of bladder LCNEC are mostly based on a limited number of research and case reports, owing to its rarity. LCNEC is still characterized by a multitude of uncertainties, hence constraining the progress and assessment of its treatment protocols. Currently, there is a lack of widely acknowledged agreement or standard for the management of LCNEC in academic settings. Nevertheless, the effectiveness of multimodal therapy has been demonstrated\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. The current chemotherapy regimens for LCNEC are based on the treatment experience of lung NE\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eRegarding prognosis, it is apparent that the survival of patients is consistently linked only to tumor-node-metastasis staging\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. The cancer infiltrated the muscularis propria at stage T2 in this case. At seven months postoperatively, there was no notable recurrence or tumor spread, indicating a favorable prognosis. This finding provides evidence for the efficacy of our diagnostic and treatment regimens in the context of this particular patient. Currently, there is a lack of a universally accepted follow-up practice for individuals diagnosed with LCNEC.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn summary, bladder LCNEC is an uncommon malignant neoplasm with a highly unfavorable prognosis. Although there are ongoing efforts to enhance patient survival through multidisciplinary therapy, the prognosis remains unfavorable. LCNEC continues to be a subject of uncertainty\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003eZhou Y was responsible for the data collection and manuscript composition; Yang L played a pivotal role in critically revising the manuscript for important intellectual content, ensuring the accuracy and integrity of the work; All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eAll data supporting the findings of this study can be found in the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics statement\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThis study has been approved by the Ethics Committee of Bishan Hospital Affiliated to Chongqing Medical University and is conducted in accordance with relevant guidelines and regulations\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent statement:\u0026nbsp;\u003c/strong\u003eInformed written consent was obtained from the patient for publication of this report and any accompanying images.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict-of-interest statement:\u0026nbsp;\u003c/strong\u003eAll authors declare that they have no conflict of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCARE Checklist (2016) statement:\u0026nbsp;\u003c/strong\u003eThe authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cstrong\u003eOlivieri V\u003c/strong\u003e, Fortunati V, Bellei L, Massarelli M, Ruggiero G, Abate D, Serra N, Griffa D, Forte F, Corongiu E. Primary small-cell neuroendocrine carcinoma of the bladder: Case report and literature review. \u003cem\u003eArch Ital Urol Androl\u003c/em\u003e 2020; \u003cstrong\u003e92\u003c/strong\u003e [PMID: 33016048 DOI: 10.4081/aiua.2020.3.211]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHalabi R\u003c/strong\u003e, Abdessater M, Boustany J, Kanbar A, Akl H, El Khoury J, El Hachem C, El Khoury R. Large Cell Neuroendocrine Carcinoma of the Bladder with Adenocarcinomatous Component. \u003cem\u003eCase Rep Urol\u003c/em\u003e 2020; \u003cstrong\u003e2020\u003c/strong\u003e: 8827646 [PMID: 33083089 DOI: 10.1155/2020/8827646]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eLopedote P\u003c/strong\u003e, Yosef A, Kozyreva O. A Case of Bladder Large Cell Carcinoma with Review of the Literature. \u003cem\u003eCase Rep Oncol\u003c/em\u003e 2022; \u003cstrong\u003e15\u003c/strong\u003e: 326-337 [PMID: 35529284 DOI: 10.1159/000521607]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAkdeniz E\u003c/strong\u003e, Bakirtas M, Bolat MS, Akdeniz S, \u0026Ouml;zer I. Pure large cell neuroendocrine carcinoma of the bladder without urological symptoms. \u003cem\u003ePan Afr Med J\u003c/em\u003e 2018; \u003cstrong\u003e30\u003c/strong\u003e: 134 [PMID: 30374380 DOI: 10.11604/pamj.2018.30.134.13437]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eNiu Q\u003c/strong\u003e, Lu Y, Xu S, Shi Q, Guo B, Guo Z, Huang T, Wu Y, Yu J. Clinicopathological characteristics and survival outcomes of bladder neuroendocrine carcinomas: a population-based study. \u003cem\u003eCancer Manag Res\u003c/em\u003e 2018; \u003cstrong\u003e10\u003c/strong\u003e: 4479-4489 [PMID: 30349380 DOI: 10.2147/CMAR.S175286]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eQuek ML\u003c/strong\u003e, Nichols PW, Yamzon J, Daneshmand S, Miranda G, Cai J, Groshen S, Stein JP, Skinner DG. Radical cystectomy for primary neuroendocrine tumors of the bladder: the university of southern california experience. \u003cem\u003eJ Urol\u003c/em\u003e 2005; \u003cstrong\u003e174\u003c/strong\u003e: 93-96 [PMID: 15947585 DOI: 10.1097/01.ju.0000162085.20043.1f]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eWang G\u003c/strong\u003e, Yuan R, Zhou C, Guo C, Villamil C, Hayes M, Eigl BJ, Black P. Urinary Large Cell Neuroendocrine Carcinoma: A Clinicopathologic Analysis of 22 Cases. \u003cem\u003eAm J Surg Pathol\u003c/em\u003e 2021; \u003cstrong\u003e45\u003c/strong\u003e: 1399-1408 [PMID: 34074810 DOI: 10.1097/PAS.0000000000001740]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSanguedolce F\u003c/strong\u003e, Cal\u0026ograve; B, Chirico M, Tortorella S, Carrieri G, Cormio L. Urinary Tract Large Cell Neuroendocrine Carcinoma: Diagnostic, Prognostic and Therapeutic Issues. \u003cem\u003eAnticancer Res\u003c/em\u003e 2020; \u003cstrong\u003e40\u003c/strong\u003e: 2439-2447 [PMID: 32366387 DOI: 10.21873/anticanres.14213]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAlijo Serrano F\u003c/strong\u003e, S\u0026aacute;nchez-Mora N, Angel Arranz J, Hern\u0026aacute;ndez C, Alvarez-Fern\u0026aacute;ndez E. Large cell and small cell neuroendocrine bladder carcinoma: immunohistochemical and outcome study in a single institution. \u003cem\u003eAm J Clin Pathol\u003c/em\u003e 2007; \u003cstrong\u003e128\u003c/strong\u003e: 733-739 [PMID: 17951193 DOI: 10.1309/HTREM6QYQDYGNWYA]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eChong V\u003c/strong\u003e, Zwi J, Hanning F, Lim R, Williams A, Cadwallader J. A case of large cell neuroendocrine carcinoma of the bladder with prolonged spontaneous remission. \u003cem\u003eJ Surg Case Rep\u003c/em\u003e 2017; \u003cstrong\u003e2017\u003c/strong\u003e: rjw179 [PMID: 28560016 DOI: 10.1093/jscr/rjw179]\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Large-cell neuroendocrine carcinoma of the bladder, Treatment, Prognosis, Case report","lastPublishedDoi":"10.21203/rs.3.rs-4693740/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4693740/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBACKGROUND\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness. The bladder is characterized by four distinct forms of neuroendocrine tumors. Among them, large-cell neuroendocrine carcinoma is the least prevalent but has the highest level of aggressiveness. To date, only a few dozen cases have been reported.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCASE SUMMARY\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHere, we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder. The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology. During hospitalization, abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder. A cystoscopic nonradical resection of the bladder lesion was performed. The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer.\u003c/p\u003e","manuscriptTitle":"Large-cell neuroendocrine carcinoma of the bladder: A case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-11 11:41:47","doi":"10.21203/rs.3.rs-4693740/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7b7317fb-3e19-4cd4-b08a-b6f79c82e2aa","owner":[],"postedDate":"August 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-10T09:41:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-11 11:41:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4693740","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4693740","identity":"rs-4693740","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}