Small cell carcinoma of the bladder
- Tanya B Dorff, MD
Tanya B Dorff, MD
- Associate Professor of Clinical Medicine
- USC Keck School of Medicine
- Norris Comprehensive Cancer Center
- David I Quinn, MBBS (Hons I), PhD, FRACP, FACP
David I Quinn, MBBS (Hons I), PhD, FRACP, FACP
- Associate Professor of Medicine
- University of Southern California Norris Cancer Center
- Keck School of Medicine
Small cell carcinoma (SCC) of the bladder is an aggressive, poorly differentiated neuroendocrine neoplasm that is similar to SCC of the lung in clinical behavior.
Although SCC is classified as a discrete entity, molecular studies have indicated that SCC is derived from the same clonal population as urothelial carcinoma (also known as transitional cell carcinoma) . Bladder SCC is frequently found in conjunction with other histologic forms of bladder cancer [2-4]. As an example, in a series of 64 cases, 44 (68 percent) had other tumor types present, including elements of urothelial cancer in 38 cases (58 percent of the total series) . Similarly, another series of 51 cases of SCC reported that elements of urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma were seen in 70, 8, and 10 percent of the cases, respectively .
SCC of the bladder will be reviewed here. Extrapulmonary SCC at other sites is discussed separately. (See "Extrapulmonary small cell cancer".)
SCC of the bladder is a rare neoplasm. For example, in the United States, it accounts for roughly 500 new cases annually. The incidence of SCC of the bladder may be increasing, based upon Surveillance, Epidemiology, and End Results (SEER)-Medicare data from the United States where the incidence rose from 0.05 to 0.14 cases per 100,000 population between 1991 and 2005 , but this still represents fewer than 1 percent of all bladder tumors .
In a 2011 analysis of patients with SCC in the SEER database, the following was noted :
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- CLINICAL PRESENTATION
- DIAGNOSTIC WORKUP
- Disease localized to the bladder
- - Neoadjuvant chemotherapy plus definitive local therapy
- Neoadjuvant chemotherapy plus cystectomy
- Neoadjuvant chemotherapy plus radiation therapy
- - Cystectomy alone
- - Role of prophylactic cranial irradiation
- Metastatic disease
- - Treatment
- SUMMARY AND RECOMMENDATIONS