Primary MiNEN of the urinary bladder: an hitherto undescribed entity composed of large cell neuroendocrine carcinoma and adenocarcinoma with a distinct clinical behavior : Description of a case and review of the pertinent literature

Virchows Arch. 2021 Jul;479(1):69-78. doi: 10.1007/s00428-021-03023-7. Epub 2021 Jan 17.

Abstract

Neuroendocrine carcinomas (NECs) of the urinary bladder are very rare and can be observed in the context of mixed neuroendocrine/non-neuroendocrine neoplasms (MiNENs), most frequently in association with urothelial carcinoma. Small cell NECs are far more common than large cell NECs (LCNECs), which are exceedingly rare. We describe a primary MiNEN of the urinary bladder, composed of a LCNEC and of an adenocarcinoma, in which the neuroendocrine component reached complete pathological regression after neoadjuvant M-VAC chemotherapy, whereas the non-neuroendocrine component of the tumor progressed to metastatic disease. Compared to mixed neuroendocrine/non-neuroendocrine neoplasms described in the literature until now, this appears to be a unique case that expands the spectrum of neuroendocrine neoplasia of the urinary bladder.

Keywords: Mixed neuroendocrine/non-neuroendocrine neoplasm; Neuroendocrine carcinoma; Neuroendocrine neoplasm; Urinary bladder.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Large Cell / secondary*
  • Carcinoma, Large Cell / therapy
  • Carcinoma, Neuroendocrine / secondary*
  • Carcinoma, Neuroendocrine / therapy
  • Cisplatin / therapeutic use
  • Cystectomy
  • Doxorubicin / therapeutic use
  • Humans
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Neoplasms, Complex and Mixed / pathology*
  • Neoplasms, Complex and Mixed / therapy
  • Prostatectomy
  • Treatment Outcome
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / therapy
  • Vinblastine / therapeutic use

Substances

  • Vinblastine
  • Doxorubicin
  • Cisplatin
  • Methotrexate

Supplementary concepts

  • M-VAC protocol