Imaging Findings of an Exophytic Urinary Bladder Paraganglioma Mimicking a Gynecological Mass: A Case Report

Urinary bladder paraganglioma (UBPGL) is a rare neuroendocrine tumor. Exophytic variants can mimic gynecological or mesenchymal pelvic masses, posing diagnostic challenges. Accurate preoperative recognition is crucial to avoid perioperative complications, especially in functional cases.

A 22-year-old asymptomatic woman presented with a slowly enlarging pelvic mass. Transrectal contrast-enhanced ultrasound (CEUS) revealed rapid, intense homogeneous early enhancement with late peripheral rim enhancement. MRI showed a markedly T2-hyperintense parauterine mass with vivid enhancement and restricted diffusion. The mass was intraoperatively confirmed to originate from the posterior bladder wall. Partial cystectomy was performed, and histopathology confirmed paraganglioma with malignant potential.

Exophytic UBPGL can mimic common pelvic tumors. Multimodality imaging, including CEUS and MRI, plays a key role in characterizing vascularity and guiding surgical planning, though diagnosis ultimately relies on histopathology and clinical correlation.