Primary large cell neuroendocrine carcinoma of the ureter

Large cell neuroendocrine carcinoma (LCNEC) is the rarest type of urinary tract malignancy. Herein, we report a case of LCNEC that arose in the ureter of a 78-year-old Japanese man with a history of ascending colon cancer that had been excised by a right hemicolectomy. Left-sided hydronephrosis asso...

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Bibliographic Details
Published in:International journal of clinical and experimental pathology 2013-01, Vol.6 (4), p.729-736
Main Authors: Oshiro, Hisashi, Odagaki, Yu, Iobe, Hiroaki, Ozu, Chouichirou, Takizawa, Issei, Nagai, Takeshi, Matsubayashi, Jun, Inagaki, Atsushi, Miyake, Shinji, Nagao, Toshitaka
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Large Cell - diagnosis
Carcinoma, Large Cell - pathology
Carcinoma, Large Cell - surgery
Carcinoma, Neuroendocrine - diagnosis
Carcinoma, Neuroendocrine - pathology
Carcinoma, Neuroendocrine - surgery
Case Report
Humans
Male
Nephrectomy
Tomography, X-Ray Computed
Treatment Outcome
Ureteral Neoplasms - diagnosis
Ureteral Neoplasms - pathology
Ureteral Neoplasms - surgery
Ureteroscopy
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Summary:Large cell neuroendocrine carcinoma (LCNEC) is the rarest type of urinary tract malignancy. Herein, we report a case of LCNEC that arose in the ureter of a 78-year-old Japanese man with a history of ascending colon cancer that had been excised by a right hemicolectomy. Left-sided hydronephrosis associated with the ureteral tumor was discovered during follow-up. A left nephroureterectomy combined with a partial resection of the urinary bladder was performed because atypical cells were detected using voided urine cytology. A histopathological examination revealed that the ureteral tumor contained large atypical epithelial cells of neuroendocrine morphology without a urothelial carcinomatous component. The neoplastic cells were immunohistochemically positive for synaptophysin, chromogranin A, CD56, and cytokeratins, but they were negative for uroplakin III and thyroid transcription factor-1. The Ki-67 labeling index of the neoplastic cells was 50%. Transmission electron microscopy demonstrated the presence of numerous dense granules in the cytoplasm of the neoplastic cells. The ureteral lesion was finally classified as stage III, pT3 cN0 cM0. The patient's postoperative course was uneventful without chemoradiotherapy, and LCNEC did not recur in the subsequent nine months. This case demonstrates that LCNEC can occur in the ureter, which normally does not contain neuroendocrine cells in the urothelium.
ISSN:1936-2625