More Common than You Would Think: A Case of Catecholamine-Secreting Paraganglioma in the Urinary Bladder (original) (raw)
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Unrecognised adrenergic symptoms and the delayed diagnosis of urinary bladder paraganglioma
Vojnosanitetski pregled, 2015
Introduction. Paraganglioma is a rare neuroendocrine neoplasm that may arise from the extra-adrenal autonomic paraganglia. Urinary bladder paraganglioma is typically presented as repeated episodes of palpitations, headache or blood pressure rise immediately after micturition. Management of these tumors includes radical surgical treatment with preoperative antihypertensive preparation, and a life-long follow-up. Case report. We presented a middle- age female patient with functional urinary bladder paraganglioma, with a 3-year history of repeated episodes of abdominal pain, dysuria and hematuria. After obtaining more precise anamnestic data, the patient reported occasional simultaneous presence of mild adrenergic symptoms, that did not cause any particular attention at first. Morphological and biohumoral examinations suggested paraganglioma of the urinary bladder. Open partial cystectomy was performed, detecting a submucosal mass, while immunohistochemical analysis confirmed the prese...
Paraganglioma of urinary bladder, an innocent rarity or a nightmare: A case series report and review
Journal of case reports and scientific images, 2023
Urinary Bladder Paraganglioma is rare form of extra-adrenal pheochromocytoma, accounting for less than 0.05% of all bladder tumours, commonly presenting with painless hematuria, headache, palpitation and micturitional syncope. Missed diagnosis of this rare condition puts patient at considerable risk, precipitating intraoperative hypertensive crisis, due to catecholamine release triggered by handling of tumour. The purpose of our presentation is to stimulate the physicians dealing with cases of bladder tumors that, with the characters of bladder tumors mentioned in the article,one should entertain a differential diagnosis of Bladder Paraganglioma, investigate to confirm the diagnosis and take appropriate measures to avoid an intraoperative mishap. We report three cases of Urinary Bladder Paraganglioma managed at a tertiary care hospital and discuss clinical features, pathology and review the previously published literature.
International Journal of Research in Medical Sciences, 2022
Urinary bladder paraganglioma (UBP) are rare neuroendocrine tumors with variable biological behavior. High index of suspicion in the preoperative evaluation would enable the clinician to formulate appropriate management of the rare tumors. Clinical and pathological data of seven cases evaluated and treated as per a devised protocol for suspected bladder paraganglioma from 2008 to 2019 was retrospectively reviewed. Among the seven cases, UBP's were predominantly seen in middle aged men. Most of these presented with storage symptoms (85.71%; n=7) and gross painless hematuria (42.85%; n=3). Three patients were hypertensives and post-micturition syncope was seen in two patients. Among the seven patients two patients had functionally active tumors confirmed by elevated urinary and serum markers for catecholamine excess. Functional tumors, nonfunctional tumors involving uretero-vesical junction or broad based polypoidal tumor were considered for partial cystectomy. Other small nonfunctional tumors underwent transurethral resection of bladder tumour (TURBT). Follow up protocol included repeat ultrasound, check cystoscopy and completion TURBT at one month and annually thereafter. Repeat urinary catecholamines at 1 month was done in functional UBP. Cystoscopic examination of a bladder lesion which are solid, sessile and predominantly intramural, a prior to a definitive planned surgery may differentiate UBP from urothelial cancer. Most of the non-functional UPB are diagnosed by histopathological examination. In symptomatic cases, functional evaluation with biochemical estimation of catecholamine excess allow better treatment planning and avoiding intraoperative hemodynamic instability. Due to high recurrence rate lifelong follow-up despite complete excision is strongly recommended.
Indian Journal of Clinical Anaesthesia
Urinary bladder paraganglioma is an extra-adrenal pheochromocytoma. As it lacks specific symptoms and because of its rare occurrence, it presents incidentally while tumour handling. A forty-eight-year-old female who presented with nausea, vomiting, weight loss, pain abdomen and hematuria was diagnosed with a bladder mass. She was scheduled for transurethral resection of the bladder tumour. On tumour manipulation, it showed numerous fluctuations in heart rate and blood pressure, from where a differential diagnosis of urinary bladder paraganglioma was made. Histopathology revealed a zellbellan pattern of paraganglioma. This case was discharged successfully postoperatively. But if undiagnosed preoperatively, it can be a real challenge because of the fatal hypertensive crisis and life-threatening cardiopulmonary complications.
Indian Journal of Pathology and Microbiology, 2014
Turnors that grow within the adrenal medulla are called pheochromocytoma; when located extra-adrenal, they are called paraganglioma. Paraganglioma of the blad.der are uiry rare, with only 180 reported cases. Less than 30 were rlalignant. We report a case of a 72-years old man with bladder paraganglioma who presented with painless hematuria. Urgent transurethral resection (TUR) was performed. Definitiue pathohistological diagnosis was confirmed to imunohistochemical and electron microscopy. Clinical diagnostic showed nonnal ualue of epinephrine and norepinehrine in the urine. Scintigraphy of entire body and targeted pictures ofpeluis where taken 24, 48 and 72 hours after ad.ministration of RL No loci of pathologic accumulation of 131-I MIBG wh.ere found. Cornputer tornography (CT) of peluis and abdomen were normal. Considering staging and pathohistological analysis, we treated our patient with TUR and longtime follow-up afterworth.
Collegium antropologicum, 2012
Tumors that grow within the adrenal medulla are called pheochromocytoma; when located extra-adrenal, they are called paraganglioma. Paraganglioma of the bladder are very rare, with only 180 reported cases. Less than 30 were malignant. We report a case of a 72-years old man with bladder paraganglioma who presented with painless hematuria. Urgent transurethral resection (TUR) was performed. Definitive pathohistological diagnosis was confirmed to imunohistochemical and electron microscopy. Clinical diagnostic showed normal value of epinephrine and norepinehrine in the urine. Scintigraphy of entire body and targeted pictures of pelvis where taken 24, 48 and 72 hours after administration of RI. No loci of pathologic accumulation of 131-I MIBG where found. Computer tomography (CT) of pelvis and abdomen were normal. Considering staging and pathohistological analysis, we treated our patient with TUR and longtime follow-up afterworth.
Nonfunctioning paraganglioma of the urinary bladder: A rare entity
Clinical Cancer Investigation Journal, 2015
Paragangliomas are extra-adrenal tumors of the autonomic nervous system and may be found within the skull base, neck, mediastinum and periaortic region. Paragangliomas of the urinary bladder are rare, and non-functioning bladder paraganglioma is even rarer and not easily recognized. Histological examination is often key in leading to a definitive diagnosis. The current report presents a case of a 28-year-old female with urinary bladder paraganglioma. The patient presented with no classical signs and symptoms, and these were only appreciated following histological examination of a transurethral resection specimen that elucidated the correct diagnosis. In the present report, the clinical features, diagnosis, management and pathological observations of paraganglioma of the urinary bladder are discussed.
Non-functioning Paraganglioma of the Urinary Bladder
Mid-Taiwan Journal of Medicine, 2009
Paragangliomas are extra-adrenal tumors of the autonomic nervous system and may be found within the skull base, neck, mediastinum and periaortic region. Paragangliomas of the urinary bladder are rare, and non-functioning bladder paraganglioma is even rarer and not easily recognized. Histological examination is often key in leading to a definitive diagnosis. The current report presents a case of a 28-year-old female with urinary bladder paraganglioma. The patient presented with no classical signs and symptoms, and these were only appreciated following histological examination of a transurethral resection specimen that elucidated the correct diagnosis. In the present report, the clinical features, diagnosis, management and pathological observations of paraganglioma of the urinary bladder are discussed.