Bladder - Carcinoid tumor

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Bladder

Other tumors

Carcinoid tumor

Reviewers: Turki Al-Hussain, M.D., Johns Hopkins Medical Centers (see Reviewers page)
Revised: 24 March 2011, last major update March 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Rare low grade neuroendocrine carcinoma, similar to counterparts at other sites

Epidemiology
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● Usually ages 47-69 years

Sites
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● Bladder neck and trigone

Etiology
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● Thought to arise from isolated neuroendocrine cells located in the basal layer of the urothelium (Epstein: Bladder Biopsy Interpretation)

Clinical features
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● Rare, < 50 cases described
● Patients present with hematuria
● No carcinoid syndrome
● Behavior is difficult to predict (Arch Pathol Lab Med 2006;130:1693); occasionally produces metastases and death

Case reports
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● 54 year old woman with tumor arising beneath an inverted papilloma (Arch Pathol Lab Med 1994;118:666)
● 62 year old woman (Arch Pathol Lab Med 1992;116:1217)
● 68 year old man with calcitonin secreting tumor (BMC Cancer 2005 Jul 27;5:88)

Treatment
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● Excision is usually curative, but behavior may not be predictable

Gross
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● Usually 1-2 cm
● Smooth-surfaced sessile polypoid nodules covered by urothelium

Micro description
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● Usually glandular growth pattern (Arch Pathol Lab Med 2003;127:e22)
● Other patterns include acinar, cribriform and trabecular
● Pure or mixed with carcinoma

Micro images
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Various images

Positive stains
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● Chromogranin, synaptophysin

Electron microscopy
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● Neuroendocrine differentiation

Differential diagnosis
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● Inverted papilloma: lacks salt and pepper chromatin of carcinoid tumors; not invasive
● Metastasis: clinical history
● Nested variant of urothelial carcinoma: classic urothelial carcinoma usually present elsewhere; usually no well defined neuroendocrine features
● Paraganglioma: nests of tumor cells surrounded by S100+ sustentacular cells
● Direct invasion of carcinoid tumor from appendix: clinical history

End of Bladder > Other tumors > Carcinoid tumor

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