膀胱副神經節瘤之案例報告及文獻回顧

張乃文¹、楊旻鑫^1,2

¹中山醫學大學附設醫院 泌尿科， ²醫學研究所

Paraganglioma of urinary bladder: a case report and literature review

Nai-Wen Chang¹, Min-Hsin Yang^1,2

Department of Urology¹, and Institute of Medicine², Chung Shan Medical University Hospital, Taichung, Taiwan

Introduction: We presented a case of paraganglioma of urinary bladder incidentally found by MRI. The extra-adrenal pheochromocytomas are known as paragangliomas and account for about 10 % of cases.

Case presentation: A 38-year-old woman did not have underlying disease such as hypertension. She suffered from hypermenorrhea with regular menstruation for years and multiple myomas was diagnosed at local clinic. MRI in 2024/01 showed multiple uterine myomas and incidental finding of nodular lesion, 1.5 cm in the urinary bladder. She did not have hematuria, dysuria nor voiding discomfort. Urine analysis showed no hematuria and urine cytology showed negative finding. Cystoscopy showed nodular lesion at posterior wall. Transurethral resection of bladder tumor was done and the pathology showed paraganglioma of urinary bladder, pT2.

Discussion: Bladder paraganglioma is a rare tumor, comprising 0.06% of all bladder tumors. It arises from chromaffin cells in the bladder wall, more common in women, often appearing in the third decade of life.  They are usually benign but 15~20% of the tumor may show malignant behavior. Functional tumors cause symptoms like hypertension, palpitations and post-micturition hypotension, while nonfunctional ones may present as painless hematuria. Diagnosis involves CT, MRI, and catecholamine level assessments. Partial cystectomy is preferred to TURBT when muscle layer invasion. Lifelong follow-up is crucial due to the risk of recurrence and metastasis.

Conclusion: Bladder paraganglioma can be functional and nonfunctional. Although it is rare, intact examination and evaluation of metastasis is essential. Bladder preservation including TURBT and partial cystectomy are mainstay of treatment for localized tumor.