Functional Bladder Paraganglioma as an Incidental Finding During Infertility Workup

Area of Science:

• Urology
• Endocrinology
• Oncology

Background:

• Bladder paragangliomas (PGLs) are rare, catecholamine-producing neuroendocrine tumors.
• They often present with micturition-related symptoms but can be asymptomatic, posing diagnostic challenges.
• Standard management includes transurethral resection or partial cystectomy.

Observation:

• An unusual case of a functional bladder PGL on the bladder dome in a 21-year-old female was incidentally detected during fertility evaluation.
• Initial suspicion arose from ultrasound and CT findings due to its hypervascular and submucosal nature.
• Biochemical confirmation preceded surgical intervention.

Findings:

• The PGL was successfully diagnosed pre-operatively through biochemical testing.
• Laparoscopic partial cystectomy guided by cystoscopy achieved good oncological and urinary outcomes.
• Fertility potential was preserved.

Implications:

• This is the first reported case of bladder PGL incidentally found during a transvaginal ultrasound for infertility.
• It underscores the importance of considering PGL in atypical bladder tumors, especially in young patients.
• Conservative, fertility-sparing surgical approaches like simultaneous laparoscopy and cystoscopy are crucial for selected cases.