A rare presentation of small cell neuroendocrine carcinoma of the bladder in a woman living with human immunodeficiency virus: a case report

Small cell neuroendocrine carcinoma (SCNEC) of the bladder is rare, aggressive, and associated with early dissemination. We report the case of a 52-year-old woman living with human immunodeficiency (HIV), virally suppressed on antiretroviral therapy (ART), who presented with painless gross haematuria. Initial imaging showed a large bladder mass without metastases. Transurethral resection confirmed SCNEC with a high proliferation index. A multidisciplinary decision was made to proceed with neoadjuvant chemotherapy with a cisplatin-etoposide regimen, followed by radical cystectomy on completion. However, on post-chemotherapy staging, disease progression was noted, and the patient died from disease-related complications. This case highlights the aggressive biology of this rare tumour and the importance of early detection and treatment.