Small cell carcinoma of the urinary bladder successfully managed with palliative radiotherapy and immunotherapy.

Abstract

Background: Small cell carcinoma of the bladder (SCCB) is a rare, poorly differentiated neuroendocrine epithelial tumour linked with a more assertive behaviour and poorer outcome than bladder transitional cell carcinoma (TCC). It is mostly diagnosed at last stage and generally believed to have a high metastatic potential. Case report: A 74 -year-old non-smoker man was having multiples episodes of gross hematuria for three months Had taken. The cystoscopical examination revealed a large mass over left lateral and anterior wall. Biopsy was taken and its evaluation revealed tumor to be small cell carcinoma. Patient had no recurrence till last follow up at two years. He died following last follow up due to cancer unrelated cause. The main aim is to describe the complete response without recurrence for two years (till cancer unrelated death) achieved in T4b stage large urinary bladder cancer using palliative radiation, 20 gy radiation(2 gy each) and TLR-2 agonist CADI-05. Conclusion: Probably the first case report describing successful bladder preserving approach using low dose (sub lethal) radiotherapy with active immunotherapy in management of T4b stage SCCB.