Malignant pheochromocytoma of the urinary bladder

A case of malignant pheochromocytoma of the urinary bladder is presented. A 54-year-old woman visited our hospital for screening and was found to have an abnormal mass in the bladder on ultrasonography. The patient was not hypertensive. Cystoscopy revealed a broad-based, small fingertip-sized, nonpapillary tumor on the posterior wall of the urinary bladder. Transurethral resection (TUR) was performed without suspicion of pheochromocytoma because of her well-controlled blood pressure and lack of characteristic symptoms. Transient elevation of systolic blood pressure to 240 mmHg occurred during resection of the tumor. Radical resection was therefore not possible. The serum norepinephrine level was elevated postoperatively. Pathologic examination revealed a malignant pheochromocytoma. On January 30, 2003, partial cystectomy of the residual tumor and pelvic lymphadenectomy were performed. She has had no clinical sign of recurrence for 1 year after the second operation.