膀胱副神經結瘤之個案報告及文獻回顧
林于巧、詹皓程、胡哲源、歐建慧
國立成功大學附設醫院 泌尿部
Case Report and Literature Review of Bladder Paraganglioma
Yu-Chiao Lin, Hau-Chern Jan, Che-Yuan Hu, Chien-Hui Ou
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
Case report:
This case is a 37 years old woman without underlying disease. She complained of lower abdominal pain, dysuria, dizziness and palpitation for about 10 days. Urinalysis showed pyuria. Bladder ultrasound revealed a bladder mass, 4cm in size, with central necrosis. Abdominal computed tomography found one enhancing bladder tumor with perivesical infiltration, cT3. Cystoscopy confirmed a bladder tumor with bullous edematous change over anterior wall. Transurethral resection was done and pathological report revealed paraganglioma. The immunohistochemical stains were positive for synaptophysin and chromogranin, but negative for cytokeratin or CD 68. Postoperative follow-up showed no evidence of tumor recurrence.
Discussion:
Bladder paraganglioma was first described by Zimmerman in 1953. It is one kind of extra-adrenal pheochromocytoma, deriving from the chromaffin cells of detrusor sympathetic plexus. Most cases occur in young adults at age of 3rd to 4th decades. Symptoms include hypertension, headache, palpitation, syncope, diaphoresis, especially during micturition. It is hard to be diagnosed before pathological proof due to non-specific symptoms. Surgery is still the mainstay of treatment. Longterm follow-up is suggested due to high recurrence rate.