單一醫院近十年來膀胱神經內分泌腫瘤-案例系列

徐易廷¹、薛又仁^1,2、黃建榮¹、蕭毅君¹、賴昱維^1,2、邱文祥^1,2

¹臺北市立聯合醫院仁愛院區 外科部 泌尿科；²國立陽明交通大學 醫學院 泌尿學科

Neuroendocrine Carcinoma of Urinary Bladder in the Past Ten Years in A Single Hospital- A Case Series

Yi-Ting Hsu¹, Thomas Y. Hsueh^1,2, Andy. C. Huang¹, Yi-Chun Hsiao¹, Yu-Wei Lai^1,2,

 Allen W. Chiu^1,2

¹Division of Urology, Department of Surgery, Taipei City Hospital renai Branch, Taipei, Taiwan;

²Department of Urology, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan

Purpose: Neuroendocrine carcinoma of urinary bladder is a rare and aggressive tumor associated with a poor prognosis. It comprises less than 1% of bladder malignancies. Our presentation is a case series of neuroendocrine carcinoma of urinary bladder, and the epidemiology, prognosis, and our treatment algorithms for patients are reviewed.

Material and methods: We identified patients from a single hospital who were diagnosed of bladder tumor of neuroendocrine carcinoma. Clinical data were obtained through reviews of medical records. The data reported here are those available in the past ten years from 2013 to 2022. Each patients had at least six months of follow-up.

Results: We identified 4 patients with confirmed urinary bladder tumor of neuroendocrine carcinoma. The mean(± SD) age of the patients was 81 ± 14 years. The most common symptoms were hematuria. All of  the 4 patients received treatment of transurethral resection of bladder tumor. Of the four patients, two are currently under treatment of concurrent chemoradiation therapy(CCRT). One received urinary diversion and ileal conduit reconstruction due to severe bilateral hydronephrosis. The other one were lost follow up since 2017 after CCRT.

Conclusions: Bladder neuroendocrine carcinoma usually presents at a later stage than urothelial carcinoma and could lead to a worse prognosis. Several treatment algorithms have been used to treat local and metastatic disease, including cystectomy, partial cystectomy, radiation therapy, and neoadjuvant/adjuvant chemotherapy or chemotherapy alone. It is difficult to exclusively advocate for one treatment algorithm due to low disease incidence. More prospective studies need to be done and development of the most effective treatment for bladder neuroendocrine carcinoma is warranted.