136 Eyelid Metastasis From Bladder Small Cell Carcinoma

Abstract

Metastases to the eyelids are rare. The primary neoplasms are more frequently in breast, skin, digestive, and urological systems. There are very few reports related to bladder carcinomas. We present a unique case of small neuroendocrine cell carcinoma of the bladder metastatic to the eyelid. A 83-year-old man was treated for a high-grade superficial urothelial bladder carcinoma in August 2013 with endoscopic resection and intravesical BCG. In November 2014, he had an in situ bladder carcinoma (CIS). In November 2015, he presented a small cell neuroendocrine carcinoma in the bladder with invasion of muscular wall and areas of in situ carcinoma with focal neuroendocrine differentiation (immunostains positive for synaptophysin and partial for chromogranin A). In October 2016, he developed a skin metastasis of the back. In January 2017, a resective biopsy from a left superior eyelid nodule revealed a small cell carcinoma. The immunohistochemical reactions showed that tumor cells were positive for synaptophysin, chromogranin A, and CD56, and negative for cytokeratin 20. Metastases to the eyelids are rare. This is the first reported case of small cell neuroendocrine carcinoma of bladder metastasizing to the eyelid. The patient had a history of high-grade superficial urothelial carcinoma, later a CIS, and then the small cell neuroendocrine carcinoma. In the study, we need to discard Merkel cell carcinoma.