Background: Smoking and occupational exposure to bladder cancer carcinogens are the major risk factors for bladder cancer development in industrialized countries, where urothelial carcinoma is the most common histologic type, accounting for >90% of cases. In Africa and the Middle East, with highly prevalent chronic infection by Schistosoma haematobium (S. haematobium), urinary bladder squamous cell carcinoma is the most prevalent histologic type of bladder cancer, followed by transitional cell carcinoma. Small cell carcinoma accounts for <1% of all primary bladder malignancies. It has the same demographic and clinical features as conventional urothelial carcinoma, and to our knowledge there is no data regarding its association with S. haematobium infection.
Case: We report on the clinicopathological characteristics of a 62-year-old, African man who presented with gross hematuria and advanced disease, resulting in a diagnosis of small cell carcinoma of the bladder associated with S. haematobium infection. He was treated with neoadjuvant chemotherapy followed by cystoprostatectomy, and remains alive after 19 months of follow-up.
Conclusion: We cannot rule out the possibility that a parasitic infection played a major role in the pathogenesis of small cell bladder carcinoma in this particular case.