Atypical presentation of bladder pheochromocytoma

Area of Science:

• Urology
• Endocrinology
• Oncology

Background:

• Bladder pheochromocytoma is an exceptionally rare neuroendocrine tumor, typically presenting with episodic symptoms like hypertension and tachycardia, often triggered by bladder activity.
• Classic symptoms include hematuria, hypertension, headache, sweating, and tachycardia, which are frequently provoked by micturition or bladder overdistention.

Observation:

• This report details a unique case of bladder pheochromocytoma in a 52-year-old woman with a 10-year asymptomatic, latent clinical course.
• The urinary bladder tumor was incidentally discovered during magnetic resonance imaging (MRI).
• Cystoscopy identified a large, submucosal tumor on the left lateral bladder wall, characterized by congested urothelium and a broad base.

Findings:

• Transurethral resection was successfully performed for the bladder tumor.
• Pathological analysis confirmed the diagnosis of pheochromocytoma.
• The patient experienced no recurrence during a 7-year follow-up period.

Implications:

• This case underscores the importance of considering rare diagnoses like bladder pheochromocytoma, even in the absence of typical symptoms.
• Incidental findings on imaging can lead to early diagnosis and successful treatment of rare tumors.
• Long-term follow-up is crucial for patients with bladder pheochromocytoma to ensure sustained remission.