2017, Number 5
Rev Mex Urol 2017; 77 (5)
Sánchez-Aquino UC, Trujillo-Ortiz LL, Sedano-Basilio J, Gómez-Sánchez J, Herrera-Muñoz J, Preciado-Estrella DA
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ABSTRACTBackground: Bladder paraganglioma is a rare tumor originating in the chromaffin embryonic tissue of the sympathetic nerves associated with the bladder wall. They can be functioning or non-functioning, depending on catecholamine secretion.
Clinical cases: A 61-year-old man sought medical attention for amorphous clot-forming gross hematuria associated with irritative urinary symptoms, palpitations, and headache during micturition. A computed tomography urogram revealed a 2.5-cm tumor in the bladder dome. Transurethral resection of the bladder tumor was performed and the outcome of the histopathologic study was bladder paraganglioma. Hormonal testing was negative and extension studies showed no evidence of metastasis. The patient successfully underwent robotic-assisted laparoscopic partial cystectomy. He is currently in follow-up, with no signs of recurrence.
Conclusions: Bladder paraganglioma is a rare tumor representing less than 0.05% of all bladder tumors and less than 1% of all pheochromocytomas. The bladder is the most common presentation site in the urinary tract (79.2%), followed by the urethra (12.7%). Clinical presentation varies, consisting mainly of headache and palpitations upon micturition. Surgery is the preferred treatment for localized paragangliomas, whereas palliative therapy is preferred for recurrent and metastatic tumors. Becuase of the extremely varied presentation of bladder paraganglioma, a high degree of suspicion is necessary in the evaluation of patients with high blood pressure and hematuria. The treatment of choice is partial cystectomy.