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Compared with pure urothelial carcinoma, the presence of a neuroendocrine component is associated with worse prognosis, supporting recognition of MiNEN as a distinct clinicopathologic entity. The article reports an elderly female case with chronic kidney disease, drug-resistant urinary tract infections, and a neurogenic bladder. Presenting symptoms included abdominal pain, urinary urgency, oliguria, dysuria, and occasional hematuria. Accurate early diagnosis relies on identifying clinicopathologic features and selecting appropriate therapeutic management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mixed-neuroendocrinenonneuroendocrine-epithelial-neoplasm-of-muscle-invasive-bladder-cancer-a-clinicopathologic-case-study/338266/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mixed-neuroendocrinenonneuroendocrine-epithelial-neoplasm-of-muscle-invasive-bladder-cancer-a-clinicopathologic-case-study/338266.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What makes mixed neuroendocrine–nonneuroendocrine epithelial neoplasm (MiNEN) in the bladder clinically distinct?","Question",{"text":113,"@type":114},"MiNEN is described as rare and highly aggressive, and the neuroendocrine component is associated with a worse prognosis than pure urothelial carcinoma, supporting its consideration as a distinct clinicopathologic entity.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What symptoms were reported at presentation in the case study?",{"text":118,"@type":114},"The patient presented with abdominal pain, urinary urgency, oliguria, dysuria, and occasional hematuria.",{"name":120,"@type":111,"acceptedAnswer":121},"Which patient history factors are highlighted in this case?",{"text":122,"@type":114},"The report emphasizes chronic kidney disease, drug-resistant urinary tract infections, neurogenic bladder, longstanding self-catheterization, and delayed cystoscopy evaluation.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},338266,1790501385,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Journal of Surgical Case Reports, 2024, 10, rjae612  \n[https://doi.org/10.1093/jscr/rjae612](https://doi.org/10.1093/jscr/rjae612)  \nCase Report  \nCase Report  \nMixed neuroendocrine–nonneuroendocrine epithelial neoplasm of muscle invasive bladder cancer: a clinicopathologic case study  \nPierre Tran 1 , P. Rama Sai2 , Chaya Prasad1 , Hanh Do1 , Cyrus Parsa1 , 3 , *  \n1 Department of Pathology, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. 2nd St. , Pomona, CA 91766, United States  \n2 Master of Sciences Department, University of Life Sciences, ul. Akademicka 13, 20-950 Lublin, Poland  \n3 Department of Pathology, Beverly Hospital, Montebello, CA 90640, United States  \n*Corresponding author. E-mail: [cparsa@westernu.edu](cparsa@westernu.edu)  \nAbstract  \nMixed neuroendocrine–nonneuroendocrine epithelial neoplasms are rare malignant neoplasms that may occur in the bladder with highly aggressive behavior. Because of its worse prognosis, when compared to the pure urothelial carcinoma without theneuroendocrine component, the bladder mixed neuroendocrine–nonneuroendocrine epithelial neoplasm may be considered a distinct clinicopathologic entity. We present a case of mixed neuroendocrine–nonneuroendocrine epithelial neoplasm occurring in the urinary bladder of an elderly female with a personal history of chronic kidney disease, drug-resistant urinary tract infections, and neurogenic bladder. Her presenting symptoms included complaints of abdominal pain, urinary urgency, oliguria, dysuria, and occasional hematuria. Recognition of the clinicopathologic features of these rare aggressive neoplasms is important for accurate early diagnosis, necessitating appropriate therapeutic management.  \nKeywords: mixed neuroendocrine–nonneuroendocrine epithelial neoplasm (MiNEN); mixed bladder cancer; divergent differentiated bladder cancer; urothelial carcinoma  \nIntroduction  \nUrothelial carcinoma has a propensity to demonstrate divergent differentiation with glandular, squamous, small-cell neuroendocrine, lymphoepithelioma-like, sarcomatoid, or other elements [1] . Neuroendocrine carcinoma (NEC) of the bladder is a very rare, highly aggressive malignancy that accounts for \u003C1% of bladder cancers with a male prevalence in the sixth to seventh decade of life [2–4] . In ∼50% of cases, they are associated with other epithelial malignancies, including a high-grade urothelial carcinoma or, more rarely, with squamous cell carcinoma oradenocarcinoma [1 , 5] . In order to unify the concept of a heterogeneous group of neoplasms, epithelial malignancies occurring in a variety of organ sites that incorporate neuroendocrine neoplasms, the term ‘mixed neuroendocrine–nonneuroendocrine neoplasms (MiNENs)’ has been proposed [6] . Such MiNENs have been reported and subjected to a literature review in the pituitary, thyroid, nasal cavity, larynx, lung, digestive system, urinary system, male and female genital organs, and skin [6] . Molecular studies of such mixed neoplasms, support a monoclonal origin, possibly from a multipotential, undifferentiated stem cell present in the urothelium [1 , 6 , 7] . Studies suggest that urinary bladder small cell, mixed-NEC, and large cell carcinoma  \n(LCNEC) constitute a morphological spectrum of high-grade neuroendocrine carcinoma (HGNEC) with overlapping histological features, immunophenotype, and a shared high proliferative rate [8] . In most cases, the presence of divergent morphology in a tumor with mixed histology is considered of questionable clinical importance compared with urothelial carcinomas of equal stage and grade, although some exceptions include small cell carcinoma and possibly micropapillary carcinoma [5] . Behavior of mixed tumors with neuroendocrine components is considerably more aggressive than in cases without small cell elements [1] . Because of its worse prognosis, MiNEN may be considered a distinct clinicopathologic entity in the bladder [6] . Molecular studies ","cbCaivO1QSG1cWRX","https://ap.wps.com/l/cbCaivO1QSG1cWRX","pdf",618454,"English","# Abstract\n# Keywords\n# Introduction\n# Case presentation","[{\"question\":\"What makes mixed neuroendocrine–nonneuroendocrine epithelial neoplasm (MiNEN) in the bladder clinically distinct?\",\"answer\":\"MiNEN is described as rare and highly aggressive, and the neuroendocrine component is associated with a worse prognosis than pure urothelial carcinoma, supporting its consideration as a distinct clinicopathologic entity.\"},{\"question\":\"What symptoms were reported at presentation in the case study?\",\"answer\":\"The patient presented with abdominal pain, urinary urgency, oliguria, dysuria, and occasional hematuria.\"},{\"question\":\"Which patient history factors are highlighted in this case?\",\"answer\":\"The report emphasizes chronic kidney disease, drug-resistant urinary tract infections, neurogenic bladder, longstanding self-catheterization, and delayed cystoscopy evaluation.\"}]","Mixed neuroendocrine–nonneuroendocrine epithelial neoplasm of muscle invasive bladder cancer - a clinicopathologic case study | PDF",1790022828]