Diagnosis and treatment of pheochromocytoma in urinary bladder

To study the diagnosis and treatment of pheochromocytoma in urinary bladder.

Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine (CA) was increased in a case, and vanillymandelic acid (VMA) was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5), computerized tomography (CT) in 3 cases (3/3), cystoscopy in 5 cases (5/6). Four cases took alpha-receptor blocker for 2 weeks, 1 case took beta-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations.

Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma postoperatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy.

Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, (131)I-MIBG (methyliodobenzylguanidine) and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.