Primary malignant neuroendocrine bladder tumours: Diagnosis and treatment

Objective: This rare bur aggressive bladder tumour presents the morphologic al and immunohistochemical characteristic, common to all neuroendocrine tum ours observed in other organs This study analyzed the diagnostic criteria a nd therapeutic results obtained in 5 consecutive patients over a 3-year per iod. Materials and Methods: 5 patients (3 men and 2 women) suffering from primar y small cell carcinoma of the bladder were evaluated. Histological diagnosi s, treatment modalities and outcome were reviewed. Results: The main clinical presentation was macroscopic haematuria. All tum ours were invasive at the time of diagnosis 4 patients were treated by tran s urethral resection alone, 2 of whom also received adjuvant radio- chemoth erapy One patient was treated by radical cystectomy. The 4 patients treated by conservative treatment modality had progression and a shorter survival, in contrast with patient treated by radical cystectomy. Conclusion: The urologist must recognize this rare histological entity whic h have a poor prognosis and requires multidisciplinary management Treatment must consist of a combination of neoadjuvant or adjuvant chemotherapy and surgery to achieve the best results.