■膀胱大细胞神经内分泌癌(LCNEC)是一种罕见的恶性肿瘤。其侵袭性高,预后差,该病常伴有转移或复发。缺乏特异性的临床表现和影像学特征给临床诊断和治疗带来了相当大的挑战。
■我们报告一例膀胱LCNEC。该患者是一名79岁的男性,因无症状性肉眼血尿反复发作而入院。根据计算机断层扫描(CT)扫描结果,我们的患者出现膀胱肿块,显示侵入浆膜层,提示肌肉受累,指示恶性肿瘤。病人接受了根治性膀胱切除术,术后病理证实为原发性,膀胱的纯LCNEC。我们给了他16个周期的toripalimab免疫疗法。作为后续行动,病人还活着,定期CT复查无复发迹象.
■我们回顾了国内外文献,发现没有明确的治疗方案。手术切除联合化疗是最常见的治疗方法。在这里,我们报告了第一例原发性病例,根治性膀胱切除术联合单纯免疫疗法治疗单纯膀胱LCNEC,实现持续缓解,为该病的免疫治疗和综合治疗提供了新的思路。
UNASSIGNED: The large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is a rare malignancy. With its high aggressiveness and poor prognosis, the disease is often accompanied by metastasis or recurrence. The lack of specific clinical manifestations and imaging features causes considerable challenges for clinical diagnosis and treatment.
UNASSIGNED: We report a case of LCNEC of the urinary bladder. The patient was a 79-year-old male admitted to our hospital with recurrent episodes of asymptomatic gross hematuria. Based on the computed tomography (CT) scan findings, our patient presented with a bladder mass displaying invasion into the serosal layer, suggestive of muscle involvement and indicative of malignancy. The patient received a radical cystectomy, and the postoperative pathology confirmed primary, pure LCNEC of the urinary bladder. We gave him 16 cycles of toripalimab immunotherapy. As of follow-up, the patient was alive, and periodic CT reexamination showed no evidence of recurrence.
UNASSIGNED: We reviewed domestic and foreign literature and found no explicit treatment protocols exist for the disease. Surgical resection combined with chemotherapy were the most common treatments. Herein, we reported the first case of primary, pure LCNEC of the urinary bladder treated by radical cystectomy combined with pure immunotherapy, achieving sustained remission, which provides a new idea for the immunotherapy and integrative treatment of the disease.