PMC7557901_01
The first bladder echography showing a thickening of the right lateral wall.
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In the emergency room, an abdominal and pelvic ultrasound showed a thickening of the right lateral wall of the bladder with mild right side hydronephrosis (Figure 1).
On the left: microscopic view of the bladder biopsy showing a proliferation of polygonal malignant cells and cylindrical cells with multiple necrotic areas; on the right: large polygonal cells with a dark and irregular nucleus and frequent metastases.
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Muscular invasion was documented with multiple necrotic areas (Figure 2).
Malignant cells showing high positivity for CD56 marker on immunohistochemistry.
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Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
Malignant cells showing high positivity of synaptophysin marker on immunohistochemistry.
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Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
Malignant cells showing minor and heterogenic positivity for cytokeratin 7 marker on immunohistochemistry.
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Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
Pelvic scan showing a 6 x 3.5 cm mass of the anterior and right lateral wall of the bladder with diffuse infiltration of the bladder fat.
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A 6 x 3.5 cm mass of the anterior and right lateral walls of the bladder was identified, with diffuse infiltration of the perivesical fat and multiple necrotic iliac lymph nodes bilaterally (Figure 6).
Pelvic scan showing the evolution of the bladder tumor.
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Four months later, after the completion of four cycles of chemotherapy, the patient underwent new assessment for disease extension (Figure 7).