Urinary Bladder Paraganglioma Unusual case with a rare Presentation A plea for Multidisciplinary Approach

Fahmy Shawish

doi:10.31579/2690-4861/002

Abstract

Urinary Bladder Paraganglioma Unusual case with a rare Presentation A plea for Multidisciplinary Approach

Highlights

Chromaffin cells are neuroendocrine cells mediate the response of stress and release catecholamines regulating the circulation and respiration
Para ganglia is a rare bladder tumor may occur in all of the age groups. It accounts for less than 0.06% of all of the bladder tumors. It is more common in females.Typically they are extra adrenal pheochromocytoma and arise from the ganglion (Chromaffin) cells of the bladder wall
Approximately 10% of them possess the capacity to invade despite their lack of mitosis and cellular dissociation which usually associated with malignant tumors. We present this case because its rarity, difficult preoperative diagnosis and the lack of related proper guide lines

Summary

Introduction

Chromaffin cells are neuroendocrine cells mediate the response of stress and release catecholamines regulating the circulation and respiration. Case presentation A 56 years old male patient retired athlete, not diabetic, not alcoholic and not smoker.The main symptom makes him to seek medical advice that he lost up to 10 Kg in the last year in spite of his regular life style His wife noticed that he had nocturia (2-3T/N) and frequency of micturition which himself thought that is the normal of athlete consuming daily adequate fluids.To elicit the cause of his weight loss initially he had gastroscopy and colonscopy. Two months later for taking a second opinion the patient visited a wellknown universal oncology center where his 17 years old daughter used to be followed for pancreatic cancer treatment He had another cystoscopy with a biopsy taken from the same site of the previously resected bladder lesion.The diagnosis of paraganglionoma pathologically was confirmed separately with this second biopsy. Three years after the initial resection, real time ultrasound scan and contrast CT scan abdomen and pelvis revealed 1 cm intramural lesion encircling the lower portion of the right ureter, otherwise bladder was normal(Figure 14,15)

Discussion

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Conclusion