Carcinoma neuroendocrino de c¨¦lulas grandes de vejiga. Revisi¨®n bibliogr¨¢fica / Large cell neuroendocrine carcinoma of the urinary bladder. Bibliographic review

RESUMEN

OBJETIVO: El Carcinoma Neuroendocrino de C¨¦lulas Grandes (CNCG), es un tumor poco frecuente en vejiga. Pretendemos actualizar los criterios diagn¨®sticos, caracter¨ªsticas anatomopatol¨®gicas e inmunohistoqu¨ªmicas, pron¨®stico y tratamiento de esta patolog¨ªa.Realizamos una revisi¨®n bibliogr¨¢fica y estudio descriptivo de los casos de CNCG de vejiga publicados en la literatura internacional.RESULTADOS: Existen 17 casos publicados de CNCG de vejiga. Las variantes histol¨®gicas mixtas constituyen el 50% y muestran escasa mejor supervivencia que las puras. El 70% son ¡ÝT3 al diagn¨®stico, y presentan una supervivencia libre de enfermedad (SLE) del 25%, mientras que la SLE para los T2 es del 100%. La cistectom¨ªa radical con linfadenectom¨ªa, combinada con quimioterapia preferiblemente neoadyuvante, consigue reducir la recurrencia local y a distancia, as¨ª como aumentar la supervivencia del CNCG de vejiga.CONCLUSIONES: El CNCG de vejiga es un tumor con alta tasa de recurrencia local y a distancia, con baja supervivencia, que requiere un diagn¨®stico precoz, y tratamiento temprano y combinado(AU)

ABSTRACT

OBJECTIVES:Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is very rare. We intend to update diagnostic criteria, pathologic and immunohistochemical characteristics, prognosis and treatment options.All published articles related with LCNEC of the urinary bladder have been reviewed and a descriptive study has been done.RESULTS: A total of 17 LCNEC of the bladder has been found. The 50% of all LCNEC of the bladder are mixed histological variant. This variant implies a better prognosis than the pure variant. The 70% of LCNEC of the bladder were ¡ÝT3 at the time of diagnosis and the survival rate was 25%, whereas T2 tumors showed a survival rate of 100%. Radical cystectomy with lymphadenectomy combined with chemotherapy can sometimes reduce local and distant recurrence and improve survival of LCNEC of the bladder. CONCLUSIONS: LCNEC of the bladder is a tumor with high rate of local and distant recurrence, as well as low survival, requiring early diagnosis and aggressive combined treatment(AU)