A rare case of bladder paraganglioma treated successfully with robotic partial cystectomy

Abstract

Bladder paragangliomas are rare extra-adrenal urological tumours which account for around 0.05% of bladder cancers. The diagnosis is often delayed due to the rarity of these tumours. There is a risk of intraoperative hypertensive crisis if not diagnosed or identified before surgical removal. We describe a case of a 36-year-old lady presented with a 10-year history of post-micturition palpitations and headaches. Her biochemical work up showed raised urinary normetanephrine levels and imaging showed a 123I MIBG-avid bladder mass, compatible with bladder paraganglioma, although interestingly almost no tracer was picked up in 68Ga DOTATATE imaging. She was started on phenoxybenzamine to control her blood pressure prior to surgery. She underwent a successful robotic partial cystectomy with no complications. After surgery she remained symptom free. Bladder paragangliomas are rare neuroendocrine tumours of the bladder which need to be diagnosed and managed effectively to avoid intra-operative and long-term complications.