Small-cell neuroendocrine carcinoma of the urinary bladder: A case report.

Primary neuroendocrine carcinomas of the urinary bladder are rare. A 60-year-old male presented with gross hematuria for the past 3 months. Diagnostic flexible cystoscopy revealed a papillary lesion above the right ureteric orifice. Transurethral resection of bladder tumor was performed and resected tissue was sent for histopathology that revealed high-grade urothelial carcinoma with small-cell neuroendocrine differentiation. Lamina propria, muscularis propria, and perineural invasion was seen which was later also confirmed by immunohistochemistry. The patient received neoadjuvant four cycles of chemotherapy and then underwent radical cystoprostatectomy with ileal conduit. The patient's recovery was uneventful and he is on regular follow-up from the past 12 months without any disease recurrence. Early detection and aggressive management can improve the survival and prognosis of these patients.

Non-Contrast Computed Tomography Scan Based Parameters of Ureteric Stones Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy.

OBJECTIVE: To compare the non-contrast computed tomography (NCCT) scan-based parameters of ureteric stones affecting the outcome of extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: We retrospectively evaluated the pre-procedure NCCT of 74 patients who had ESWL for solitary ureteric calculi of 5-20 mm in diameter. We assessed the age, sex, basal metabolic index (BMI), laterality, location, presence of double 'J' (DJ) stent, skin to stone distance (SSD), stone maximum diameter, Hounsfield unit (HU), Hounsfield density (HD), area, and volume. All those who had no stone on follow-up imaging within 30 days were declared successful while those who had residual stone were declared failures. RESULTS: The overall success rate was 78% (58/74). Sixty (81.1%) patients were male. The success of ESWL was correlated with lower SSD, Hounsfield units (HU) and Hounsfield density (HD). However, in multivariate analysis, SSD, Hounsfield unit, and stone area showed correlation with success of procedure but Hounsfield density failed to show correlation. The success rate in patients with stone HU <500, 500-1000 and >1000 were 93.9%, 69%, and 58.3%, respectively. Patients with lower BMI (<30 kg/m2) and HD (<76 HU/mm) were more prone towards success of the procedure than those with higher BMI (>30 kg/m2) and higher HD (>76 HU/mm). CONCLUSION: BMI, SSD, stone Hounsfield units and Hounsfield unit density were strong predictors of outcome of ESWL for ureteric stone.