Abstract
Small cell urothelial carcinoma remains virtually indistinguishable from its counterpart in the lung. Typically comprised of small, round blue cells with hyperchromatic nuclei and a high nuclear to cytoplasmic ratio, these tumors are associated with a very rapid proliferation rate and early metastases. Upstaging at surgery is quite common and is likely the reason for the poor clinical outcomes seen with initial cystectomy. Recent data from the first clinical trial in small cell urothelial cancer suggest more long-term survivors when chemotherapy is given prior to cystectomy. Chemotherapy followed by radiation may be a reasonable alternative in patients with tumors clinically confined to the bladder. However, the frequent presence of other variant histology and carcinoma in situ associated with small cell urothelial cancer may be one reason for the higher relapse rates, including local failure in the bladder, seen with bladder irradiation. Unfortunately, the prognosis in the setting of metastatic disease remains quite poor with an average life expectancy on the order of 1 year. Additional data indicate the incidence of brain metastases may be as high as 50 % in patients with stage 3 or greater tumors, suggesting a subset of patients in which one may consider prophylactic cranial irradiation. However, the numbers of patients treated with these paradigms remain low. Additional work is required to optimize the treatment for patients with this rare malignancy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Sternberg CN, Swanson DA. Non-transitional cell bladder cancer. In: Raghavan D, Scher HI, Leiber SA, Lange P, editors. Principles and practice of genitourinary oncology. Philadelphia: Lippincott - Raven Publishers; 1997. p. 322–3.
Choong NW, Quevedo JF, Kaur JS. Small cell carcinoma of the urinary bladder. The Mayo Clinic experience. Cancer. 2005;103(6):1172–8.
Cheng L, Pan CX, Yang XJ, Lopez-Beltran A, MacLennan GT, Lin H, et al. Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer. 2004;101(5):957–62.
Siefker-Radtke AO, Dinney CP, Abrahams NA, Moran C, Shen Y, Pisters LL, et al. Evidence supporting preoperative chemotherapy for small cell carcinoma of the bladder: a retrospective review of the M. D. Anderson cancer experience. J Urol. 2004;172(2):481–4.
Siefker-Radtke AO, Kamat AM, Grossman HB, Williams DL, Qiao W, Thall PF, et al. Phase II clinical trial of neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin in small-cell urothelial cancer. J Clin Oncol. 2009;27(16):2592–7.
Walther PJ. Adjuvant/neo-adjuvant etoposide/cisplatin and cystectomy for management of invasive small cell carcinoma of the bladder. J Urol. 2002;167(4):285.
Quek ML, Nichols PW, Yamzon J, Daneshmand S, Miranda G, Cai J, et al. Radical cystectomy for Âprimary neuroendocrine tumors of the bladder: the university of southern california experience. J Urol. 2005;174(1):93–6.
Abrahams NA, Moran C, Reyes AO, Siefker-Radtke A, Ayala AG. Small cell carcinoma of the bladder: a contemporary clinicopathological study of 51 cases. Histopathology. 2005;46(1):57–63.
Blomjous CE, Vos W, De Voogt HJ, Van der Valk P, Meijer CJ. Department of Pathology FUHATN. Small cell carcinoma of the urinary bladder. A clinicopathologic, morphometric, immunohistochemical, and ultrastructural study of 18 cases. Cancer. 1989;64(6):1347–57.
Sved P, Gomez P, Manoharan M, Civantos F, Soloway MS. Small cell carcinoma of the bladder. BJU Int. 2004;94(1):12–7.
Grignon DJ, Ro JY, Ayala AG, Shum DT, Ordâoänez NG, Logothetis CJ, et al. Small cell carcinoma of the urinary bladder. A clinicopathologic analysis of 22 cases. Cancer. 1992;69(2):527–36.
Christopher ME, Seftel AD, Sorenson K, Resnick MI. Small cell carcinoma of the genitourinary tract: an immunohistochemical, electron microscopic and clinicopathological study. J Urol. 1991;146(2):382–8.
Cheng L, Jones TD, McCarthy RP, Eble JN, Wang M, MacLennan GT, et al. Molecular genetic evidence for a common clonal origin of urinary bladder small cell carcinoma and coexisting urothelial carcinoma. Am J Pathol. 2005;166(5):1533–9.
Tamas EF, Stephenson AJ, Campbell SC, Montague DK, Trusty DC, Hansel DE. Histopathologic features and clinical outcomes in 71 cases of bladder diverticula. Arch Pathol Lab Med. 2009;133(5):791–6.
Amin MB. Histological variants of urothelial carcinoma: diagnostic, therapeutic and prognostic implications. Mod Pathol. 2009;22 Suppl 2:S96–118.
Pant-Purohit M, Lopez-Beltran A, Montironi R, MacLennan GT, Cheng L. Small cell carcinoma of the urinary bladder. Histol Histopathol. 2010;25(2):217–21.
Ismaili N, Arifi S, Flechon A, El Mesbahi O, Blay JY, Droz JP, et al. Small cell cancer of the bladder: pathology, diagnosis, treatment and prognosis. Bull Cancer. 2009;96(6):E30–44.
Buza N, Cohen PJ, Pei H, Parkash V. Inverse p16 and p63 expression in small cell carcinoma and high-grade urothelial cell carcinoma of the urinary bladder. Int J Surg Pathol. 2010;18(2):94–102.
Abbas F, Civantos F, Benedetto P. Small cell carcinoma of the bladder and prostate. Urology. 1995;46(5):617–30.
Bastâus R, Caballero JM, Gonzâalez G, Borrat P, Casalots J, Gomez de Segura G. Small cell carcinoma of the urinary bladder treated with chemotherapy and radiotherapy: results in five cases. Eur Urol. 1999;35(4):323–6.
Bex A, de Vries R, Pos F, Kerst M, Horenblas S. Long-term survival after sequential chemoradiation for limited disease small cell carcinoma of the bladder. World J Urol. 2009;27(1):101–6.
Asmis TR, Reaume MN, Dahrouge S, Malone S. Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at the Ottawa Hospital Regional Cancer Center. BJU Int. 2006;97(4):711–5.
Lohrisch C, Murray N, Pickles T, Sullivan L, British Columbia Cancer Agency VBCC. Small cell Âcarcinoma of the bladder: long term outcome with integrated chemoradiation. Cancer. 1999;86(11):2346–52.
Papandreou CN, Daliani DD, Thall PF, Tu SM, Wang X, Reyes A, et al. Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate. J Clin Oncol. 2002;20(14):3072–80.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media New York
About this chapter
Cite this chapter
Parwani, A., Dinney, C., Siefker-Radtke, A. (2012). Small Cell Urothelial Carcinoma. In: Hansel, D., McKenney, J., Stephenson, A., Chang, S. (eds) The Urinary Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5320-8_9
Download citation
DOI: https://doi.org/10.1007/978-1-4614-5320-8_9
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-5319-2
Online ISBN: 978-1-4614-5320-8
eBook Packages: MedicineMedicine (R0)