Carcinome neuroendocrine à petites cellules des voies urinaires excrétrices supérieures : à propos d'un cas

Small cell neuroendocrine carcinoma of the upper urinary tract is extremely rare. To our knowledge, only 25 cases have been reported in the literature. The current study reports the case of an 80-year-old patient who suffered from macroscopic haematuria. A first screening by thoracic-abdominal-pelvic CT scan showed a mass located in the patient's left ureter and a left nephro-ureterectomy was consequently performed. The pathological examination of the resected specimen allowed the diagnosis of a small cell neuroendocrine carcinoma of the left ureter. After four months of follow-up, a PET-CT detected an isolated local recurrence on the left common iliac lymphadenopathy. After seven cycles of chemotherapy (carboplatin-etoposide), we observed a partial response followed by a new progression. It was then decided to perform an image-guided radiotherapy at a dose of 46.8 Gy, at 1.8 Gy per fraction, during 37 days to the left common iliac lymphadenopathy. After 16 months of follow-up, a complete metabolic remission was achieved. Indeed, this observation, followed by a short literature review, demonstrates the interest of radiotherapy for the treatment of a rare cancer: the small cell neuroendocrine carcinoma of the upper urinary tract.