Diagnosis, investigations and treatment
In terms of blood work, results from 26/09/2023 showed within normal
range electrolytes, renal function tests, liver function tests, lipid
profile, inflammatory markers, PSA, Troponin T, HbA1c, and NT-proBNP.
Imaging studies included a chest X-ray and KUB X-ray which showed no
abnormal findings. A CT scan performed on 26/09/2023 revealed a
lobulated heterogeneous enhancing urinary bladder mass measuring 6.4 cm
x 6.2 cm (Fig. 1 a-b), an enlarged prostate measuring 6.8 cm x 6 cm x
6.5 cm, a Bosniak 1 cyst in the left kidney, pelvic lymph node
enlargement, femoral lymph node enlargement on both sides, and
spondylosis of the thoracic and lumbar spine.
With the surgery performed on 28/09/2023, which included a Radical
Cystoprostatectomy and Ileal Conduit, along with pelvic lymph node
dissection. The histology report reveals a diagnosis of Neuroendocrine
Carcinoma – T2B, involving the entire bladder and comprising a Large
Cell Component (20%) and a Small Cell Component (80%) with
immunohistochemical staining revealing positivity for synaptophysin,
CD56 and AE1/3.
The tumor extends into the deep muscle propria, with no involvement of
the prostate or soft tissue, while lymph-vascular invasion is present.