case_images: PMC11184159_01
case_images: Cystoscopic visualizations of the patient. (A) Initial cystoscopy showing large cell neuroendocrine carcinoma within the bladder. (B) Posttreatment visualization indicating local scar tissue formation following comprehensive treatment, including TURBT, secondary resection, chemotherapy, and radiotherapy. (C and D) Comparative cystoscopy images captured before and after electrocauterization of the bladder scar tissue one year after TURBT.
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case_images: The initial diagnostic assessments, including cystoscopy (Figure 1) and imaging studies (CT urography and pelvic MRI), revealed a solid tumor measuring 2.1x2.0 x 2.1 cm on the left posterior wall of the bladder.
case_images: Radiological Imaging of the Patient. (A) Axial CTU view. (B) Sagittal CTU projection. (C) Coronal CTU image. CT urography revealed a nodular soft tissue mass measuring approximately 2.1 cm x 2.0 cm x 2.1 cm on the bladder's left posterior wall, with surface calcification and mild to moderate enhancement following contrast agent administration. (D) Axial MR image. (E) Sagittal MR image. (F) Coronal MR image. MRI scans display heterogeneous signal intensities within the bladder lesion, with isointense T1 and slightly hyperintense T2 signals.
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case_images: There was no evidence of tumor extension beyond the bladder or significant lymph node enlargement (Figure 2).
case_images: Histopathological and immunohistochemical staining of the tumor. (A) LCNEC of the bladder showed large cells with large nuclear size, prominent nucleoli, and abundant cytoplasm. (H&E staining, x100). (B) The neoplasm displayed positive expression of Synaptophysin. (C) The neoplasm displayed positive expression of CgA. (D) Positive for CD56. (E) Positive for GATA3. (F) High proliferative index with Ki67 at 80%.
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case_images: Immunohistochemical staining showed positivity for CD56, Chromogranin A, Synaptophysin, and GATA3, with a Ki-67 labeling index of 80%, confirming the diagnosis of LCNEC (Figure 3).