原发性膀胱大细胞神经内分泌癌(LCNEC)是一种罕见的,侵袭性肿瘤复发率高,预后差。传统的治疗方法严重依赖根治性膀胱切除术,which,尽管它很有侵略性,往往导致不满意的结果。新出现的证据表明侵入性较小的潜力,保留膀胱的方法,然而,详细的报告和长期结果仍然很少。我们报告了一个开创性的病例,一名59岁的男性被诊断为原发性膀胱LCNEC,通过开创性的保留膀胱的多模式治疗来管理。这种新策略包括经尿道切除,然后是量身定制的化学放射方案,在20个月的随访期内,导致特殊的疾病控制和膀胱功能的保留,没有复发的证据。此病例强调了膀胱保护策略作为根治性膀胱切除术管理LCNEC的合法替代方法的可行性。为希望保持膀胱功能的患者提供希望的灯塔。它促使人们重新评估传统的治疗模式,并倡导进一步研究多模式,这种具有挑战性的恶性肿瘤的器官保护方法。
Primary bladder large cell neuroendocrine carcinoma (
LCNEC) is a rare, aggressive neoplasm with high recurrence rates and poor prognosis. Traditional management has heavily relied on radical cystectomy, which, despite its aggressiveness, often results in unsatisfactory outcomes. Emerging evidence suggests the potential for less invasive, bladder-sparing approaches, yet detailed
reports and long-term outcomes remain scarce. We report a groundbreaking
case of a 59-year-old male diagnosed with primary bladder
LCNEC, managed through a pioneering bladder-sparing multimodal treatment. This novel strategy included transurethral resection followed by a tailored chemoradiation protocol, resulting in exceptional disease control and preservation of bladder function over a 20-month follow-up period, without evidence of recurrence. This
case underscores the viability of bladder conservation strategies as a legitimate alternative to radical cystectomy for managing
LCNEC, presenting a beacon of hope for patients wishing to preserve bladder functionality. It prompts a reevaluation of traditional treatment paradigms and advocates for further research into multimodal, organ-sparing approaches for this challenging malignancy.