Díaz-Núñez JR, Hernández-Martinez G, Rodríguez-Montes CE, Flores-Terrazas EJ, Castro-Marín M, López-Silvestre JC, Campos-Salcedo JG, Zapata-Villalba MA, Mendoza-Alvarez LA, Estrada-Carrasco CE

Language: Spanish
References: 10
Page: 172-175
PDF size: 374.56 Kb.

ABSTRACT

Background: Paraganglioma represents less than 0.05% of bladder cancer that is non-dependent on the urothelium. Germ line mutations in B, C, and D subunit- coding genes of the succinate dehydrogenase mitochondrial Complex II are associated with multiple paragangliomas. When bladder paraganglioma is suspected, cystoscopy should be carried out after previous adrenergic block. Biopsy is not recommended in tumors because they are hypervascularized and generally covered with normal urothelium. Treatment for localized tumor is transurethral resection. Partial cystectomy is recommended when tumors are large or there has been lymph node extension.
Case presentation: Patient is a 66-year-old woman whose disease began in July 2008 with three events of macroscopic hematuria. Cystoscopy identified pinkish, smooth-edged pedunculated tumor with wide base and approximately 5 cm of abundant retrotrigonal vascularization. Bladder tumor was resected and histopathological study reported paraganglioma invading the muscularis propria of the bladder.
Discussion: Bladder paraganglioma belongs to nonurothelial bladder tumors and the classic triad of clinical symptoms is silent macroscopic hematuria (present in 60% of reported cases), paroxysmal hypertension, and “urinary attacks”. Patient progress was good after surgical treatment and up to the present there have been no malignancy indicators. However, due to the fact that treatment was conservative the patient is now under 6-month surveillance.

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