PDF(Pubmed)
Abstract：
Bladder paraganglioma is a rare neuroendocrine neoplasm, either functional or non-functional, arising from the urinary bladder. Functional variants present with catecholamine-related symptoms, while non-functional variants pose diagnostic challenges, mimicking urothelial carcinoma. Misdiagnosis risks underscore the importance of accurate identification for appropriate patient management. In this case, a 52-year-old man, diagnosed incidentally with hypertension and reported occasional post-micturition tachycardia, underwent abdominal ultrasound for known hepatic cyst follow-up, revealing an oval hypoechoic bladder mass. Initial consideration of bladder urothelial carcinoma prompted further investigation with contrast-enhanced CT scan and cystoscopy that confirmed extrinsic mass nature, and subsequent robotic-assisted partial cystectomy was performed. Histologically, the removed mass exhibited characteristic features of bladder paraganglioma. Postoperative recovery was uneventful, with resolution of post-micturition tachycardia at 1 month. Follow-up includes endocrinological evaluation and a 6-month CT scan. In conclusion, bladder paraganglioma should be considered in para-vesical mass differentials. This case highlights the importance of meticulous history collection, even in asymptomatic patients, the need for a multidisciplinary approach for accurate diagnosis and management of this rare condition, and the robotic approach as a viable option.
摘要：
膀胱副神经节瘤是一种罕见的神经内分泌肿瘤，功能性或非功能性，从膀胱产生的。存在儿茶酚胺相关症状的功能变异，虽然非功能性变异带来了诊断挑战，模仿尿路上皮癌。误诊风险强调了准确识别对适当患者管理的重要性。在这种情况下,一个52岁的男人,偶然诊断为高血压，并报告偶尔出现排尿后心动过速，接受了腹部超声检查以进行已知的肝囊肿随访，显示椭圆形低回声膀胱肿块。膀胱尿路上皮癌的最初考虑促使通过对比增强CT扫描和膀胱镜检查进一步研究，证实了外源性肿块性质。随后进行机器人辅助膀胱部分切除术.组织学上,切除的肿块表现出膀胱副神经节瘤的特征性特征。术后恢复顺利，1个月时排尿后心动过速消退。随访包括内分泌评估和6个月的CT扫描。总之,膀胱旁神经节瘤应考虑膀胱旁肿块差异。这个案例凸显了精心收集历史的重要性,即使在无症状的患者中，需要多学科方法来准确诊断和治疗这种罕见的疾病，和机器人方法作为一个可行的选择。
