Primary Small Cell Carcinoma of the Ureter-A Case Report and Review of the Literature

Abstract

Introduction: Small cell carcinoma usually arises in the lung but can also originate in a wide range of extrapulmonary sites. Extrapulmonary small cell carcinoma is rare, encompassing approximately 0.1-0.4 percent of all small cell carcinomas, and has been described in a variety of organs. Small cell carcinoma of the genitourinary tract is often found in the urinary bladder, and is extremely rare in the ureter. Case report: A 56-year-old man was admitted with a two-month history of the right flank pain. An abdominal computed tomography demonstrated an infiltrative mass lesion with size of about 8.5 × 7.6 cm in the right pelvis, arising from the right ureter, with severe right hydronephrosis and hydroureter. The patient received neoadjuvant chemotherapy with cisplatin and gemcitabine for 3 cycles, followed by right side hand-assisted retroneoscopic nephroureterectomy. Then adjuvant concurrent chemo-radiotherapy was given. The chemotherapy regimens were cisplatin and etoposide for 3 cycles. The irradiation course consisted of 64.8 Gy/36 fractions to the tumor bed. Discussion: The most common symptoms of this disease are gross hematuria and flank pain. The staging of this disease is according to small cell carcinoma of the lung. The treatment of ureter small cell carcinoma is not well established. Despite adjuvant chemotherapy or radiotherapy, most patients develop metastatic disease resulting in poor prognosis of this disease. Aggressive treatment is warranted to improve the outcome. However, the tolerance of the patients is still needed to be considered.