Abstract
Background Although both nonfunctional paraganglioma of the bladder (NPB) and urothelial carcinoma of the bladder (UCB) are subtypes of bladder tumors, they are entirely different entities with distinct tissue origins and anatomical locations. However, NPB is frequently misdiagnosed as UCB chiefly due to the similarities in their clinical characteristics and cystoscopic features. This study aimed to compare the differences in their clinical characteristics and cystoscopic features. Patients and Methods Between April 2007 and September 2017, 14 patients with NPB (NPB group) were retrieved from 2 centers, and 42 patients with new-onset UCB (UCB group) were randomly retrieved. Demographic, symptomatic, imaging, and cystoscopic data of patients in both groups were collected and compared. Results NPB group comprised 7 males and 7 females, with a mean age of 43.1 ± 13.6 years. Compared with the UCB group, patients in the NPB group were significantly younger (p < 0.001), less likely to be male (p < 0.05), and to present with hematuria (p < 0.01). However, no significant difference in maximum tumor diameter was observed between the 2 groups (p=0.609). Compared with the UCB group, cystoscopically, patients in the NPB group were significantly more likely to present with hypervascularization but less likely to present with hemorrhage, necrosis, calcification, pedunculation, and multilesion (p < 0.05). No patients with NPB were clinically diagnosed correctly before cystoscopy. Of the 5 patients who underwent both cystoscopy and biopsy, 4 were diagnosed with NPB, while 1 remained undiagnosed. Of the remaining 9 patients who underwent cystoscopy only, 5 were diagnosed with nonepithelial tumor, and 4 were misdiagnosed with UCB. Conclusions Age, sex, and hematuria may provide clues to differentiating NPB from UCB. Differences in cystoscopic features between NPB and UCB are of high diagnostic value. Cystoscopic biopsy should be considered in the preoperative diagnosis of NPB.
Highlights
Paragangliomas of the bladder are rare tumors originating from the autonomic paraganglion tissues embedded in the muscular layer or the lamina propria [1, 2] instead of the epithelial layer. ey are divided into functional and nonfunctional phenotypes. e latter, nonfunctional paragangliomas of the bladder (NPBs), lack typical manifestations of catecholamine syndrome [3] and account for approximately 38.7% of all paragangliomas of the urinary bladder
Patients in the nonfunctional paraganglioma of the bladder (NPB) group were significantly less likely to present with hematuria than patients in the urothelial carcinoma of the bladder (UCB) group (35.7% vs 83.3%, p < 0.01)
Patients in the NPB group were significantly more likely to present with hypervascularization (71.4% vs 21.4%, p < 0.01) than patients in the UCB group
Summary
Paragangliomas of the bladder are rare tumors originating from the autonomic paraganglion tissues embedded in the muscular layer or the lamina propria [1, 2] instead of the epithelial layer. ey are divided into functional and nonfunctional phenotypes. e latter, nonfunctional paragangliomas of the bladder (NPBs), lack typical manifestations of catecholamine syndrome [3] and account for approximately 38.7% of all paragangliomas of the urinary bladder. As opposed to NPBs, UCBs arise from the epithelial layer of the bladder wall, frequently presenting with painless hematuria or occasionally without any symptoms. Us, symptomatically NPBs extremely mimic UCBs. As opposed to NPBs, UCBs arise from the epithelial layer of the bladder wall, frequently presenting with painless hematuria or occasionally without any symptoms. Both NPB and UCB are subtypes of bladder tumors, they are independent entities with distinct tissue origins and anatomical locations. Both nonfunctional paraganglioma of the bladder (NPB) and urothelial carcinoma of the bladder (UCB) are subtypes of bladder tumors, they are entirely different entities with distinct tissue origins and anatomical locations. Compared with the UCB group, patients in the NPB group were significantly younger (p < 0.001), less likely to be male (p < 0.05), and to present with hematuria (p < 0.01). Cystoscopic biopsy should be considered in the preoperative diagnosis of NPB
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