Bladder paraganglioma treated with open partial cystectomy: a case report.


Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
25 Dec 2022
Historique:
received: 19 08 2022
accepted: 08 12 2022
entrez: 24 12 2022
pubmed: 25 12 2022
medline: 28 12 2022
Statut: epublish

Résumé

Bladder paraganglioma is a neuroendocrine tumor that accounts for less than 0.1% of all bladder tumors. Symptoms caused by catecholamine release such as hypertension, palpitation, syncope, and macroscopic hematuria are the most common findings. Treatment modalities include transurethral resection, and partial or total cystectomy. A 38-year-old Turkish female patient was examined for hematuria that had been persisting for 6 months. Among the clinical findings, only hematuria was present. Absence of adrenergic symptoms such as hypertension, palpitations, and syncope at the first presentation made it difficult to consider bladder paraganglioma in the differential diagnosis. Therefore, cystoscopy and transurethral resection were performed with the thought of urothelial cancer. Findings such as hypertension and bradycardia that developed during diagnostic transurethral resection suggested that it might be bladder paraganglioma. After the radiological evaluation and endocrinological preparation, the patient underwent partial cystectomy. The rarity of cases having been reported in the literature leads to uncertainties in the management of bladder paraganglioma. Adrenergic symptoms developing during transurethral resection should suggest paraganglioma in the differential diagnosis. A multidisciplinary approach and medical treatment are mandatory to prevent life-threatening complications such as hypertensive crisis, vascular collapse, and multiple-organ system failure. We aimed to report the clinical presentation that includes only macroscopic hematuria mimicking urothelial cancer and to emphasize the multidisciplinary approach in the treatment.

Sections du résumé

BACKGROUND BACKGROUND
Bladder paraganglioma is a neuroendocrine tumor that accounts for less than 0.1% of all bladder tumors. Symptoms caused by catecholamine release such as hypertension, palpitation, syncope, and macroscopic hematuria are the most common findings. Treatment modalities include transurethral resection, and partial or total cystectomy.
CASE PRESENTATION METHODS
A 38-year-old Turkish female patient was examined for hematuria that had been persisting for 6 months. Among the clinical findings, only hematuria was present. Absence of adrenergic symptoms such as hypertension, palpitations, and syncope at the first presentation made it difficult to consider bladder paraganglioma in the differential diagnosis. Therefore, cystoscopy and transurethral resection were performed with the thought of urothelial cancer. Findings such as hypertension and bradycardia that developed during diagnostic transurethral resection suggested that it might be bladder paraganglioma. After the radiological evaluation and endocrinological preparation, the patient underwent partial cystectomy.
CONCLUSION CONCLUSIONS
The rarity of cases having been reported in the literature leads to uncertainties in the management of bladder paraganglioma. Adrenergic symptoms developing during transurethral resection should suggest paraganglioma in the differential diagnosis. A multidisciplinary approach and medical treatment are mandatory to prevent life-threatening complications such as hypertensive crisis, vascular collapse, and multiple-organ system failure. We aimed to report the clinical presentation that includes only macroscopic hematuria mimicking urothelial cancer and to emphasize the multidisciplinary approach in the treatment.

Identifiants

pubmed: 36566235
doi: 10.1186/s13256-022-03715-x
pii: 10.1186/s13256-022-03715-x
pmc: PMC9790119
doi:

Substances chimiques

Adrenergic Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

479

Informations de copyright

© 2022. The Author(s).

Références

Ann Pathol. 2017 Dec;37(6):444-456
pubmed: 29169836
BMJ Case Rep. 2020 Mar 12;13(3):
pubmed: 32169989
Arch Esp Urol. 2021 May;74(4):445-449
pubmed: 33942738
N Engl J Med. 1953 Jul 2;249(1):25-6
pubmed: 13063676
Case Rep Urol. 2019 Nov 12;2019:4549790
pubmed: 31886013
Medicine (Baltimore). 2021 Aug 27;100(34):e26909
pubmed: 34449457
J Urol. 2011 Jul;186(1):279-80
pubmed: 21600612

Auteurs

Tugay Aksakallı (T)

Department of Urology, Erzurum Regional Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. tugay.aksakalli@saglik.gov.tr.

Bakytbek Kozubaev (B)

Department of Urology, Ataturk University Medical Faculty, Erzurum, Turkey.

Turgut Yapanoğlu (T)

Department of Urology, Ataturk University Medical Faculty, Erzurum, Turkey.

Adem Utlu (A)

Department of Urology, Erzurum Regional Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Fatih Alper (F)

Department of Radıology, Ataturk University Medical Faculty, Erzurum, Turkey.

Arzu Bilen (A)

Department of Endocrınology, Ataturk University Medical Faculty, Erzurum, Turkey.

Numan Bulut (N)

Department of Pathology, Ataturk University Medical Faculty, Erzurum, Turkey.

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