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© The Author(s) 2025 Article reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/23523735251370956](DOI: 10.1177/23523735251370956)[ ](DOI: 10.1177/23523735251370956)[journals.sagepub.com/home/blc](journals.sagepub.com/home/blc)  \nNicholas I Simon 1 , Andre R Kydd 1, Dilara Akbulut2, David Takeda 1,  \nJaydira Del Rivero3, Maria Merino2, Bernadette Redd4, Liza Lindenberg5, Esther Mena5, Elias Chandran 1, Sandeep Gurram6, Salah Boudjadi 1, Scot Niglio 1, Parth Sharma7  , Anish Thomas7 and Andrea B Apolo 1  \nAbstract  \nSmall cell carcinoma of the bladder (SCCB) is a rare, aggressive malignancy that accounts for less than 1% of all bladder cancers. In this report, we highlight the clinical manifestations of SCCB (including epidemiology, cystoscopic and imaging findings), summarize insights into the molecular mechanisms underlying its pathophysiology, detail current methods of staging, review local and systemic treatment, and explore novel agents currently in clinical development. Most of the regimens used for SCCB treatment are extrapolated from small cell lung cancer, a more common cancer that shares theneuroendocrine and aggressive clinical phenotype of SCCB. Greater preclinical research can help to elucidate pertinent similarities and differences between SCCB and other neuroendocrine cancers as well as reveal new therapeutic targets, while increased participation of patients with SCCB in clinical trials may provide additional treatment options for patients with this aggressive cancer.  \nKeywords  \nsmall cell carcinoma of the bladder, high grade neuroendocrine carcinoma, rare genitourinary malignancy  \nReceived: 27 March 2025; accepted: 6 August 2025  \nIntroduction  \nBladder cancer is the tenth most common cancer worldwide, with an estimated 550,000 new cases diagnosed each year.1 More than 90% are urothelial carcinoma (UC), some with histologic subtype morphologies (micropapillary, sarcomatoid, glandular, etc.);2 and some with divergent differentiation including squamous and glandular. Small cell carcinoma of the bladder (SCCB) can exist as a pure small cell phenotype but is most commonly found mixed with UC. SCCB is a rare and aggressive neuroendocrine malignancy accounting for \u003C1% of all bladder cancers. Given its rarity, clinical decisions are largely informed by case reports, retrospective analyses, and extrapolation from related histologies such as small cell lung cancer (SCLC) . Here we review current knowledge of the pathogenesis, presentation, workup, and management of SCCB.  \n1 Genitourinary Malignancies Branch, Center for Cancer Research, National Institutes of Health, Bethesda, MD, USA  \n2Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA  \n3Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA  \n4Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA  \n5Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA  \n6Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 7Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA  \nCorresponding author:  \nAndrea B Apolo, Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.  \nEmail: [andrea.apolo@nih.gov](andrea.apolo@nih.gov)  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution  \nNonCommercial 4.0 License ([https://creativecommons.org/licenses/","cbCaim6esZqMieA8","https://ap.wps.com/l/cbCaim6esZqMieA8","pdf",7471928,"English","# Abstract\n# Introduction\n# Epidemiology\n# Pathogenesis","[{\"question\":\"What is small cell carcinoma of the bladder (SCCB) and how common is it?\",\"answer\":\"SCCB is a rare, aggressive neuroendocrine malignancy accounting for less than 1% of all bladder cancers.\"},{\"question\":\"What major clinical and diagnostic features does the review cover for SCCB?\",\"answer\":\"The review highlights clinical manifestations including epidemiology, cystoscopic findings, and imaging findings.\"},{\"question\":\"How does the review describe treatment planning for SCCB?\",\"answer\":\"Most treatment regimens are extrapolated from small cell lung cancer, reflecting shared neuroendocrine and aggressive clinical phenotypes, and the review also summarizes staging and current local and systemic treatment options plus emerging agents.\"}]","Small cell carcinoma of the bladder - Review of pathogenesis, presentation, and management | PDF",1790200082,48]