Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report

Ghassen Tlili; Houssem Ammar; Wiem Majdoub; Sonia Dziri; Waad Farhat; Emir Acacha; Rahul Gupta; Najmeddine Jalleli; Awatef Azzabi; Mehdi Jaidane

doi:10.1016/j.amsu.2021.102475

Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report

Ann Med Surg (Lond). 2021 Jun 6:67:102475. doi: 10.1016/j.amsu.2021.102475. eCollection 2021 Jul.

Authors

Affiliations

¹ Department of Urology, Sahloul Hospital, Sousse, Tunisia.
² Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia.
³ Department of Anatomopathology, Sahloul Hospital, Sousse, Tunisia.
⁴ Department of Nephrology, Sahloul Hospital, Sousse, Tunisia.
⁵ Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India.

Abstract

Background: Neuroendocrine carcinomas of the urinary bladder are rare tumors, estimated at less than 1% of urinary bladder malignancies. They are mainly represented by small cell neuroendocrine carcinoma, while large cell neuroendocrine carcinoma (LCNEC) is rarely reported.

Case presentation: We report a case of a 49-year-old man presenting paraplegia caused by a metastatic urinary bladder LCNEC, which was managed with palliative external beam radiotherapy (EBRT) associated with MVAC chemotherapy, including methotrexate, vinblastine sulfate, doxorubicin hydrochloride (Adriamycin), and cisplatin. At the last follow-up of one year after his admission, there was a symptomatic improvement in the pain intensity.

Conclusion: LCNEC of the bladder was first described in 1986, and, until now, less than 40 cases have been published in the literature. To the best of our knowledge, this is the first case of primary LCNEC of the urinary bladder presenting with paraplegia.

Keywords: Large cell neuroendocrine carcinoma; Paraplegia.

Publication types

Case Reports