2020 Volume 62 Issue 12 Pages 3072-3078
An 82-year-old man was referred to our hospital with a complaint of hematuria. Bladder endoscopy revealed a mass lesion in the left side of the urinary bladder and urine cytology showed class Ⅴ. He was diagnosed with bladder carcinoma based on these results. Transurethral resection of the bladder tumor was performed. Histopathological examination showed features of small cell carcinoma. The pretreatment diagnosis was small cell carcinoma of the bladder, T3b N0 M0 stage Ⅳ according to the TMN classification. The patient was treated by systemic chemotherapy and radiation therapy. Eight months after diagnosis, he complained of jaundice and anorexia. Contrast-enhanced computed tomography revealed a hypovascular tumor in the pancreatic head with the largest diameter of 37mm. Endoscopic ultrasonography (EUS) revealed a 35mm lesion that contained hyper- and hypoechoic areas in the pancreatic head. EUS-guided fine needle aspiration (FNA) was performed and histopathological examination revealed small cell carcinoma. Immunohistochemical examination revealed synaptophysin- and CD56- positive, chromogranin-negative tumor cells, which were similar to the primary urinary bladder tumor cells. Thus, we diagnosed the lesion as pancreatic metastasis from small cell carcinoma of the urinary bladder. Despite chemotherapy with gemcitabine after diagnosis, the patient died two months later.
