Microcytic carcinoma of the urinary bladder: Experience over 22 years

Abstract Introduction Microcytic carcinoma of the urinary bladder or bladder small cell carcinoma (SCC) is a rare entity, characterized by an aggressive behavior, with a poor prognosis, elevated metastatic potential, and is commonly found in older patients and in advanced disease stages. Here we present our experiences with the behavior of the disease and the treatments applied. Material and method This was a retrospective study on patients diagnosed with bladder SCC in our hospital between February 1992 and February 2014. We analyzed the demographic and clinical characteristics of the tumor, the applied treatments and survival. We performed a descriptive statistical analysis of the median follow-up time, overall survival (OS) and cancer-specific survival (CSS), using the SPSS statistical package v. 15.0. Results Over 22 years, 20 patients with an average age of 75 years were diagnosed with bladder SCC (2 female). The predominant symptom was macroscopic haematuria (75%). After the first transurethral resection (TUR) of the bladder and the histological diagnosis, 35% (7 patients) did not receive additional treatment, 15% (3 patients) were treated with chemoradiotherapy (CRT), 10% (2 patients) with TUR, 15% (3 patients) with chemotherapy (QT), 5% (1 patient) with TUR associated to CRT, 5% (1 patient) with radical surgery, 5% (1 patient) with radical surgery treatment followed by adjuvant CRT, 5% (1 patient) with palliative surgery (hypogastric arteriae ligation) followed by adjuvant QT and 5% (1 patient) with hemostatic radiotherapy (RT). With a median follow-up time of 13.8 months, the OS was 14.48 months (95% CI: 6.22–22.75) and the CSS 18.04 months (95% CI: 6.51–29.57). Only 10% (2 patients) survived till the end of the study. Conclusion Microcytic carcinoma of the urinary bladder is a rare and aggressive entity commonly diagnosed in males of advanced age and in advanced disease stages. It has a poor prognosis and reduced survival. Due to its aggressiveness previous to the initial diagnosis, a cystectomy is only possible in very few cases; therefore multimodal treatment is necessary. This treatment is yet to be defined.