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Case Reports
. 2024 May 31:14:1390350.
doi: 10.3389/fonc.2024.1390350. eCollection 2024.

Ureter mixed neuroendocrine-non-neuroendocrine neoplasm: a case report and literature review

Bing Zhou  1 , Xing Gan  2 , Xiaohua Li  3 , Lizi Peng  4 , Hua Hao  5
Affiliations
Case Reports

Ureter mixed neuroendocrine-non-neuroendocrine neoplasm: a case report and literature review

Bing Zhou et al. Front Oncol. .

Abstract

Cases of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) of the urinary system are rare, and reports of primary MiNENs in the ureter are lacking. Herein, we present the case of a 71-year-old man who presented with painless gross hematuria and weight loss. Contrast-enhanced abdominal computed tomography (CT) revealed a tumor, comprising small cell neuroendocrine carcinoma (SCNEC) and adenocarcinomatous components, attached to the ureter. The SCNEC components were strongly positive for synaptophysin, CD56 and INSM1 and adenocarcinomatous components were strongly positive for CDX2 and cytokeratin 20, respectively. Four weeks post-surgery, the patient received four cycles of cisplatin-based chemotherapy; the 7-month follow-up CT confirmed that he was healthy without disease recurrence. The occurrence of MiNEN in the ureter with SCNEC and adenocarcinomatous components is extremely rare, wherein histopathological and immunohistochemical features aid in the diagnosis MiNEN. With its aggressive nature, MiNEN can only be effectively treated by early diagnosis and radical surgery.

Keywords: MiNEN; diagnosis; immunohistochemistry; mixed neuroendocrine-non-neuroendocrine neoplasm; ureter.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Contrast-enhanced computerized tomography (CECT) of the left ureteral segment and left hydronephrosis. CECT revealed a 20-mm lesion on the left ureteral segment. Neuroendocrine carcinoma and adenocarcinoma in biopsy. Low ((B), hematoxylin-eosin, × 40) and intermediate [(C), hematoxylin-eosin, × 200] magnification showing adenocarcinoma and Neuroendocrine carcinoma. Neuroendocrine in biopsy: High magnification [(D), hematoxylin-eosin, × 400]. Adenocarcinoma in biopsy: High magnification [(E), hematoxylin-eosin, × 400].
Figure 2
Figure 2
Neuroendocrine carcinoma and adenocarcinoma in biopsy. Low [(A), hematoxylin-eosin, × 40]. Immunohistochemical staining showed positivity for a urothelial marker [(GATA3 (B)], neuroendocrine marker [synaptophysin (C)], adenocarcinoma marker [CDX2 (D)], a neuroendocrine marker [CD56 (E)], adenocarcinoma marker [CDX2 (F), epithelial marker (CKpan (G)], a neuroendocrine marker [INSM1 (H)], a neuroendocrine marker [SSTR2 (I)] and proliferation index marker [Ki67 (J)].
Figure 3
Figure 3
A timeline figure summarising the case diagnosis and treatment pathway.
See this image and copyright information in PMC

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