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Non-functional muscle-invasive bladder paraganglioma-a case report.

Joshua S Jue^1,2, Jonathan Weinreich^1,2, Noel A Armenakas^1,2

¹Department of Urology, Lenox Hill Hospital, Northwell Health, New York, NY, USA.

AME Case Reports

|October 9, 2024

Summary

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Overcoming Understaging and Undergrading in Upper Tract Urothelial Carcinoma. Comment on Ghoreifi et al. Modern Kidney-Sparing Management of Upper Tract Urothelial Carcinoma. <i>Cancers</i> 2023, <i>15</i>, 4495.

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Extra-adrenal pheochromocytoma (paraganglioma) of the urinary bladder is rare but can be aggressive. Early recognition and surgical resection are key for managing this tumor and preventing complications like hypertensive crisis.

Area of Science:

Urology
Endocrinology
Surgical Oncology

Background:

Extra-adrenal pheochromocytoma, or paraganglioma, is a rare urinary bladder tumor (0.05% of bladder tumors).
These tumors, most common in the genitourinary tract, possess aggressive malignant potential, necessitating complete surgical resection.
Paragangliomas can be non-functional or functional, secreting catecholamines, and are challenging to differentiate from urothelial carcinoma.

Observation:

A rare case of a non-functional paraganglioma in the bladder of a 46-year-old male is presented.
The tumor's location near the bladder neck required specialized equipment for visualization.
A golden-yellow sessile mass was observed during surgical resection.

Findings:

Intraoperative manipulation of bladder paragangliomas can precipitate a catecholamine surge, leading to complications.

Keywords:

Paraganglioma case report non-functional paraganglioma variant histology bladder cancer

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Gross visualization of a golden-yellow sessile bladder mass should raise suspicion for paraganglioma.

Biochemical evaluation of catecholamines, metanephrines, and normetanephrines is crucial for assessing tumor functionality.

Implications:

Preoperative or early intraoperative recognition of bladder paraganglioma is vital for implementing appropriate alpha blockade.
Hemodynamic optimization and surgical management are essential for suspected localized bladder paraganglioma.
Prompt recognition facilitates minimizing patient morbidity and preventing intraoperative hypertensive crises.