Paraganglioma of urinary bladder.

Abstract

Received June 2007 Accepted September 2007 INTRODUCTION Paraganglioma of the urinary bladder is rarely encountered and its biological behavior is uncertain. It represents less than 1% of the bladder tumors and is usually benign. The tumor usually develops in young adult women.(1) The most prevalent involved sites are discussed controversially in the literature. In a recently published work, lateral and posterior walls of the bladder are described as the most prevalent sites, while in the latest edition of the CampbellWalsh Urology, the trigones and the posterior wall have been stated as the most common tumor sites for paraganglioma.(2,3) Common symptoms and signs are dysuria, hematuria, and hypertension, caused by local irritation of the tumor, and increased catecholamine levels. As many as 50% of the paragangliomas are hereditary and may be associated with familial paraganglioma, neurofibromatosis type 1, von HippelLindau disease, and the Carney triad.(4) We report a single case of paraganglioma in the urinary bladder primarily diagnosed as myoma. CASE REPORT A 37-year-old woman presented with frequency and dysuria. Physical examination showed no abnormalities. No constitutional symptoms suggesting an endocrine active paraganglioma, such as hypertension, were detected. Transabdominal ultrasonography showed a low-echoic mass at the bottom of the bladder. To prove the ultrasonographic diagnosis, conventional cystoscopy was performed and led to the diagnosis of a 2-cm myoma. Since infiltration of the muscle layer was ruled out by computed tomography, we decided to perform transurethral resection of the tumor (Figure 1). However, during the first transurethral resection, infiltration of the muscle layer was seen and confirmed by Urol J. 2008;5:57-9. www.uj.unrc.ir