Abstract
ABSTRACTPurpose As a rare bladder tumor, paraganglioma of the urinary bladder (PUB) is frequently misdiagnosed as bladder cancer, particularly for the non-functional type. To date, transurethral resection remains a controversial treatment for non-functional PUB. This study aimed to identify the clinical features, pathological characteristics, prognosis, and safe/effective treatment of non-functional PUB using transurethral resection of the bladder tumor (TURBT).Materials and Methods The clinical records, radiological data, pathological characteristics and follow-up times were retrospectively reviewed in 10 patients with clinically and pathologically proven non-functional PUB in our hospital from January 2008 to November 2016. All patients underwent TURBT treatment.Results The incidence of non-functional PUB in patients with bladder cancer was 0.17%. The mean age at diagnosis was 44.5 ± 13.6 years (range, 29-70 years), and the patient population had a female: male ratio of 3: 2. No patients had excess catecholamine (CA) whilst four patients had painless hematuria. All neoplasms were completely resected via TURBT. The majority of samples were positive for immunohistochemical markers including chromogranin A (CgA) and Synaptophysin (Syn), but were negative for cytokeratins (CKs). Only a single recurrence was observed from the mean follow-up period of 36.4 ± 24.8 months.Conclusion Complete TURBT is a safe and efficient treatment that serves both diagnostic and therapeutic purposes. Histopathological and immunohistochemistry examinations are mandatory for diagnostic confirmation. Long-term follow-up is recommended for patients with non-functional PUB.
Highlights
Paraganglioma of the urinary bladder (PUB) is a rare type of bladder tumor that accounts for approximately 0.06% of bladder tumors, 1% of pheochromocytomas, and 10% of paragangliomas [1]
Based on the content and activity of catecholamine (CA) that arise from the tumor, extra-adrenal paraganglioma can be classified as functional or non-functional
We report the clinical features, pathological characteristics, and prognosis of patients diagnosed as non-functional PUB treated by transurethral resection of the bladder tumor (TURBT) in our hospital
Summary
Paraganglioma of the urinary bladder (PUB) is a rare type of bladder tumor that accounts for approximately 0.06% of bladder tumors, 1% of pheochromocytomas, and 10% of paragangliomas (extra-adrenal pheochromocytoma) [1]. Based on the content and activity of catecholamine (CA) that arise from the tumor, extra-adrenal paraganglioma can be classified as functional (chromaffin) or non-functional (non-chromaffin). The former clinically manifests as hematuria or catecholamine-related symptoms including micturition syncope, hypertension, headache, palpitations and transient hypertension after urination. The latter shows no obvious symptoms, but compression occurs when the tumor becomes large. As the clinical presentation of PUB did not occur during the early disease stages, clinicians were unaware of the tumor, frequently leading to misdiagnosis or missed diagnosis, for the non-functional type
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