Department of Urological Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China.
Department of General Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, Jiangsu, P.R. China.
Diagn Pathol. 2023 Jul 11;18(1):80. doi: 10.1186/s13000-023-01369-x.
Urothelial carcinoma is a major subtype of bladder cancer and small cell carcinoma (SCC) is a rare type of cancer in clinical practice. Pathologic collision of urinary bladder urothelial carcinoma with SCC is not common in clinical settings.
Here, we report a patient with high-grade papillary carcinoma which changed to collision tumor with SCC. The patient underwent radical cystectomy; however, neck and mediastinum lymph nodes metastases were detected 11 months after the operation. The lymph nodes were diagnosed pathologically as SCC. Chemoradiotherapy was subsequently prescribed. Unfortunately, this patient died of COVID-19 in early 2023.
We hypothesized the mechanism underlying this pathological transformation. For patients with urothelial bladder cancer, pathological analysis should be conducted to allow standardized and persistent treatment. Moreover, drugs should be selected depending on the type of pathology, especially for patients who develop relapse, since collision tumor or other pathological tumors may be present.
We recommend that radical cystectomy be performed early enough for patients with non-muscle invasive bladder cancer, who are at a high risk of tumor recurrence. However, this conclusion needs to be validated in a larger number of patients.
尿路上皮癌是膀胱癌的主要亚型，小细胞癌（SCC）是临床实践中罕见的癌症类型。膀胱尿路上皮癌与 SCC 的病理性碰撞在临床环境中并不常见。
本研究报告了一例高级别乳头状癌转变为 SCC 碰撞瘤的患者。该患者接受了根治性膀胱切除术；然而，术后 11 个月发现颈部和纵隔淋巴结转移。淋巴结病理诊断为 SCC。随后给予化疗和放疗。不幸的是，该患者于 2023 年初因 COVID-19 去世。
我们推测了这种病理转化的机制。对于患有膀胱癌的患者，应进行病理分析，以便进行标准化和持续的治疗。此外，应根据病理类型选择药物，特别是对于复发的患者，因为可能存在碰撞瘤或其他病理肿瘤。
我们建议对高危肿瘤复发的非肌肉浸润性膀胱癌患者尽早进行根治性膀胱切除术。然而，这一结论需要在更多的患者中进行验证。
