A rare case of primary malignant small cell carcinoma combined with urothelial cell carcinoma in the ureter

World Journal of Surgical Oncology

Dong Seok Han²  Jong Ok Kim¹  Seung Mo Yuk²  Hoon Jang² 

[1] Department of Pathology, The Catholic University of Korea Daejeon St. Mary’s Hospital, Daeheung-dong, Jung-gu, Daejeon, 301-723, Korea;Department of Urology, The Catholic University of Korea Daejeon St. Mary’s Hospital, Daeheung-dong, Jung-gu, Daejeon, 301-723, Korea

关键词: Urothelial cell carcinoma;    Ureter;    Small cell carcinoma;    Adjuvant treatment;   

Others  :  823523
DOI  :  10.1186/1477-7819-11-181

 received in 2013-03-09, accepted in 2013-07-30,  发布年份 2013

【 摘 要 】

Background

Extrapulmonary small cell carcinomas have been reported in a variety of organs, and their incidence in the genitourinary tract is second only to that in the gastrointestinal tract. To date, however, only a few cases of small cell carcinoma of the ureter have been reported. Because the extreme rarity of this type of carcinoma, its clinical behaviour, diagnostic methods, and effective treatment modalities have not yet been determined.

Case presentation

A 59-year-old man presented with a 1-month history of painless gross haematuria. Urine cytopathology revealed a urothelial carcinoma and computed tomography revealed left hydronephroureterosis with a distal ureteral stone and a mildly enhanced fungating mass just below the stone-impacted site. The preoperative TNM stage was T2N0M0. The patient underwent simultaneous diagnostic ureterorenoscopy and left laparoscopic nephroureterectomy with bladder cuff resection. Gross examination showed a 3.5 × 3.0 × 0.8 cm white, partly yellow mass in the left distal ureter. Light microscopy showed a small cell carcinoma, overlaid on a urothelial carcinoma in situ, invading the ureter and external lateral resection margins. The small cell carcinoma was diffusely positive for neuron-specific enolase, and exhibited focal positivity for CD 56, synaptophysin, chromogranin and cytokeratin 20. The patient was treated with adjuvant chemotherapy, consisting of cisplatin and etoposide, and radiation therapy, and has been well, without evidence of tumour recurrence or metastasis in the 10 months after surgery.

Conclusion

Small cell carcinoma of the ureter is rare. Although its clinical behaviour and diagnostic modalities have not been determined and it has yet to be diagnosed immunohistopathologically, multimodality treatment including surgery, chemotherapy and radiotherapy may improve patient survival.

【 授权许可】

   
2013 Jang et al.; licensee BioMed Central Ltd.

【 图 表 】

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