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Organo Oficial de la Sociedad Mexicana de Urología

2017, Number 5

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Rev Mex Urol 2017; 77 (5)

Robotic-assisted laparoscopic partial cystectomy in a patient with bladder paraganglioma

Sánchez-Aquino UC, Trujillo-Ortiz LL, Sedano-Basilio J, Gómez-Sánchez J, Herrera-Muñoz J, Preciado-Estrella DA

Language: Spanish
References: 20
Page: 393-400
PDF size: 415.47 Kb.


ABSTRACT

Background: Bladder paraganglioma is a rare tumor originating in the chromaffin embryonic tissue of the sympathetic nerves associated with the bladder wall. They can be functioning or non-functioning, depending on catecholamine secretion.
Clinical cases: A 61-year-old man sought medical attention for amorphous clot-forming gross hematuria associated with irritative urinary symptoms, palpitations, and headache during micturition. A computed tomography urogram revealed a 2.5-cm tumor in the bladder dome. Transurethral resection of the bladder tumor was performed and the outcome of the histopathologic study was bladder paraganglioma. Hormonal testing was negative and extension studies showed no evidence of metastasis. The patient successfully underwent robotic-assisted laparoscopic partial cystectomy. He is currently in follow-up, with no signs of recurrence.
Conclusions: Bladder paraganglioma is a rare tumor representing less than 0.05% of all bladder tumors and less than 1% of all pheochromocytomas. The bladder is the most common presentation site in the urinary tract (79.2%), followed by the urethra (12.7%). Clinical presentation varies, consisting mainly of headache and palpitations upon micturition. Surgery is the preferred treatment for localized paragangliomas, whereas palliative therapy is preferred for recurrent and metastatic tumors. Becuase of the extremely varied presentation of bladder paraganglioma, a high degree of suspicion is necessary in the evaluation of patients with high blood pressure and hematuria. The treatment of choice is partial cystectomy.


REFERENCES

  1. Kappers MH, van den Meiracker AH, Alwani RA, Kats E, Baggen MG. Paraganglioma of the urinary bladder. Neth J Med 2008;66:163-165.

  2. Lai Y, Chen D, Yu Z, et al. Non-functioning paraganglioma of the urinary bladder: A case report and review of the literature. Oncol Lett. 2014;7(3):891-893.

  3. Elder EE, Elder G, Larsson C. Pheochromocytoma and functional paraganglioma syndrome: no longer the 10% tumor. J Surg Oncol. 2005;89:193-201.

  4. Kato H, Suzuki M, Mukai M, Aizawa S. Clinicopathological study of pheochromocytoma of the urinary bladder: immunohistochemical, flow cytometric and ultrastructural findings with review of the literature. Pathol Int 1999;49:1093-1099.

  5. Zimmerman IJ, Biron RE, MacMahon HE. Pheochromocytoma of the urinary bladder. N Engl J Med 1953;249:25-26.

  6. Nayyar R, Singh P, Gupta NP: Robotic management of pheochromocytoma of the vesicoureteric junction. JSLS. 2010;14:309-312.

  7. Pandey R, Garg R, Roy K, Darlong V, Punj J, Kumar A. Perianesthetic management of the first robotic partial cystectomy in bladder pheochromocytoma. A case report. Minerva Anestesiol 2010;76:294-297.

  8. Oderda M, Michelon F, Appendino M, et al. Primary bladder phaeochromocytoma diagnosed by a Vet. Scand J Urol Nephrol 2010;44:186-189.

  9. Vesin C, Cadi P, Thony F, et al. A rare cause of complicated hypertension: urinary bladder paraganglioma. South Med J 2009;102:1173-1175.

  10. Huang Y, Tian XJ, Ma LL. Pre-peritoneal laparoscopic partial cystectomy of the bladder pheochromocytoma. Chin Med J 2009;122:1234-1237.

  11. Dhawan DR, Ganpule A, Muthu V, Desai MR. Laparoscopic management of calcified paraganglioma of bladder. J Urol. 2008;5:126-128.

  12. Im SH, Kim NH. Thunderclap headache after micturition in bladder pheochromocytoma. Headache 2008;48:965- 967.

  13. Siatelis A, Konstantinidis C, Volanis D, Leontara V, Thoma- Tsagli E, Delakas D. Pheochromocytoma of the urinary bladder: report of 2 cases and review of literature. Italian J Urol Nephrol 2008;60:137-140.

  14. Kappers MH, van den Meiracker AH, Alwani RA, Kats E, Baggen MG. Paraganglioma of the urinary bladder. Neth J Med 2008;66:163-165.

  15. Zwahlen D, Fishman PN, Honey J, Milosevic M, Tannock I. Malignant pheochromocytoma of the urinary bladder. Can J Urol 2007;14:3455-3457.

  16. Bhalani SM, Casalino DD, Manvar AM: Paraganglioma of the bladder. J Urol 2011;186:279-280.

  17. Kang SG, Kang SH, Choi H, Ko YH, Park HS, Cheon J. Robotassisted partial cystectomy of a bladder pheochromocytoma. Urol Int 2011;87:241-244.

  18. Havekes B, Corssmit EP, Jansen JC, van der Mey AG, Vriends AH, Romijn JA. Malignant paragangliomas associated with mutations in the succinate dehydrogenase D gene. J Clin Endocrinol Metabol 2007;92:1245-1248.

  19. Tsutsui A, Omoto K, Eto M, Naito S. Unsuspected pheochromocytoma of the urinary bladder in an 81-year-old woman. Hinyokika Kiyo 2006;52:577-579.

  20. Bozbora A, Barbaros U, Erbil Y, Kilicarslan I, Yildizhan E, Ozarmagan S. Laparoscopic treatment of hypertension after micturition: Bladder pheochromocytoma. JSLS. 2006;10:263-266.




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