Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report

BACKGROUND: Neuroendocrine carcinomas of the urinary bladder are rare tumors, estimated at less than 1% of urinary bladder malignancies. They are mainly represented by small cell neuroendocrine carcinoma, while large cell neuroendocrine carcinoma (LCNEC) is rarely reported. CASE PRESENTATION: We report a case of a 49-year-old man presenting paraplegia caused by a metastatic urinary bladder LCNEC, which was managed with palliative external beam radiotherapy (EBRT) associated with MVAC chemotherapy, including methotrexate, vinblastine sulfate, doxorubicin hydrochloride (Adriamycin), and cisplatin. At the last follow-up of one year after his admission, there was a symptomatic improvement in the pain intensity. CONCLUSION: LCNEC of the bladder was first described in 1986, and, until now, less than 40 cases have been published in the literature. To the best of our knowledge, this is the first case of primary LCNEC of the urinary bladder presenting with paraplegia.