Bladder paragangliomas: a pictorial review

Withey, Samuel; Christodoulou, Dimitra; Prezzi, Davide; Rottenberg, Giles; Sit, Cherry; Ul-Hassan, Fahim; Carroll, Paul; Velusamy, Anand; Izatt, Louise; Nair, Rajesh; Jacques, Audrey

doi:10.1007/s00261-022-03443-2

Cited by 9 publications

(4 citation statements)

References 48 publications

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“…On ultrasound, a sharply demarcated soft tissue mass with solid or focal necrotic features and vascularity on colour doppler may be seen 22. Typically, the appearance is that of a hypoechoic subserosal tumour, as seen in this case, although hyperechoic areas and calcific changes may be seen 23. Cross-sectional CT classically shows increased attenuation on unenhanced imaging and avid arterial contrast enhancement with prominent peritumour vessels, particularly in larger tumours 24…”

Section: Discussionmentioning

confidence: 89%

Unrecognised paraganglioma of the urinary bladder precipitating hypertensive crisis

Youssef,

Sewell,

Grills

2024

BMJ Case Rep

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Bladder paragangliomas (bPGLs) account for only 0.06% of all bladder tumours, most commonly presenting with post-micturition syncope and hypertensive crisis. Silent paragangliomas are very rare, and failure to recognise them in the perioperative setting can precipitate a hypertensive crisis in the absence of sufficient alpha-blockade. Here, we describe a case of unrecognised bPGL in a woman with pre-existing hypertension and a single prior episode of haematuria thought to be related to urothelial carcinoma. She was found to have a low-grade non-invasive papillary urothelial carcinoma (potentially the cause of her haematuria) and an unrelated vascular-appearing tumour causing hypertensive crisis and broad complex tachycardia on resection. This was confirmed to be a bPGL on histology for which she underwent definitive management with a partial cystectomy following blood pressure management.

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Section: Discussionmentioning

confidence: 89%

Unrecognised paraganglioma of the urinary bladder precipitating hypertensive crisis

Youssef,

Sewell,

Grills

2024

BMJ Case Rep

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“… 10 Ultrasound highlights hypoechoic lesions with increased blood flow in 60% of cases, while CT displays hyperdense, rounded lesions with arterial phase enhancement, peritumoral vessels, and occasional calcification. 11 magnetic resonance imaging (MRI), more sensitive than CT, provides excellent soft tissue contrast, depicting hyperintense tumors with diffusion restriction and a ‘salt and pepper’ appearance in larger cases. 12 In contrast to MRI, iodine 131 metaiodobenzylguanidine scintigraphy has high specificity and could be used to help diagnose the tumor.…”

Section: Discussionmentioning

confidence: 99%

Mastering bladder paraganglioma for optimal treatment: a case report of robot-assisted surgery

Orsini,

Ferretti,

Tamborino

et al. 2024

Therapeutic Advances in Urology

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Bladder paraganglioma is a rare neuroendocrine neoplasm, either functional or non-functional, arising from the urinary bladder. Functional variants present with catecholamine-related symptoms, while non-functional variants pose diagnostic challenges, mimicking urothelial carcinoma. Misdiagnosis risks underscore the importance of accurate identification for appropriate patient management. In this case, a 52-year-old man, diagnosed incidentally with hypertension and reported occasional post-micturition tachycardia, underwent abdominal ultrasound for known hepatic cyst follow-up, revealing an oval hypoechoic bladder mass. Initial consideration of bladder urothelial carcinoma prompted further investigation with contrast-enhanced CT scan and cystoscopy that confirmed extrinsic mass nature, and subsequent robotic-assisted partial cystectomy was performed. Histologically, the removed mass exhibited characteristic features of bladder paraganglioma. Postoperative recovery was uneventful, with resolution of post-micturition tachycardia at 1 month. Follow-up includes endocrinological evaluation and a 6-month CT scan. In conclusion, bladder paraganglioma should be considered in para-vesical mass differentials. This case highlights the importance of meticulous history collection, even in asymptomatic patients, the need for a multidisciplinary approach for accurate diagnosis and management of this rare condition, and the robotic approach as a viable option.

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“…PUB shows significant enhancement after intravenous injection of Gd-DTPA[ 6 , 8 ]. Radionuclide-labeled metaiodobenzyl guanidine (MIBG) imaging can combine the functional characteristics of pheochromocytoma with morphological changes with high accuracy and specificity[ 9 ]. PUB showed hypermetabolic lesions on 131 I MIBG SPECT/CT.…”

Section: Discussionmentioning

confidence: 99%

Nonfunctional bladder paraganglioma misdiagnosed as hemangioma: A case report

Chen¹,

Yang²

2022

WJCC

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BACKGROUND Paraganglioma of the urinary bladder (PUB) is a nonepithelial tumor of the bladder that is also known as bladder pheochromocytoma. The incidence of nonfunctional paraganglioma of the urinary bladder is rare in clinical practice. CASE SUMMARY A case of nonfunctional paraganglioma of the urinary bladder diagnosed and treated in our hospital is reported herein. A 2.5 cm × 2.1 cm moderate-echo mass protruding into the right anterior wall of the bladder was incidentally found during transvaginal color Doppler ultrasound examination. Based on a contrast-enhanced computed tomography scan of the bladder, the right anterior wall of the bladder was considered to present a hemangioma. The patient underwent laparoscopic partial resection of the bladder wall in our hospital, and pathological results showed paraganglioma of the bladder. At present, we have followed up with the patient for half a year, and there has been no recurrence of the tumor. CONCLUSION The imaging patterns of PUB and bladder hemangioma are similar. In clinical practice, the possibility of PUB should be considered for a single wide-based isoechoic mass in the bladder, especially functional PUB may cause some adverse effects during surgery.

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Bladder paragangliomas: a pictorial review

Cited by 9 publications

References 48 publications

Unrecognised paraganglioma of the urinary bladder precipitating hypertensive crisis

Unrecognised paraganglioma of the urinary bladder precipitating hypertensive crisis

Mastering bladder paraganglioma for optimal treatment: a case report of robot-assisted surgery

Nonfunctional bladder paraganglioma misdiagnosed as hemangioma: A case report

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