Paraganglioma of the urinary bladder - clinicopathological, immunohistochemical and electron microscopy analysis - a case report [Paragangliom mokraćnog mjehura - kliničko-patološka i imunohistokemijska analiza - prikaz slučajeva]

Peršec, Zoran and Buković, Damir and Peršec, Jasminka and Sović, Tomislav and Ljubanović, Danica and Lambaša, Smiljka and Radan, Mirjana and Babić, Ivan (2012) Paraganglioma of the urinary bladder - clinicopathological, immunohistochemical and electron microscopy analysis - a case report [Paragangliom mokraćnog mjehura - kliničko-patološka i imunohistokemijska analiza - prikaz slučajeva]. Collegium Antropologicum, 36 (3). pp. 1041-1043. ISSN 0350-6134

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Abstract

Tumors that grow within the adrenal medulla are called pheochromocytoma; when located extra-adrenal, they are called paraganglioma. Paraganglioma of the bladder are very rare, with only 180 reported cases. Less than 30 were malignant. We report a case of a 72-years old man with bladder paraganglioma who presented with painless hematuria. Urgent transurethral resection (TUR) was performed. Definitive pathohistological diagnosis was confirmed to imunohistochemical and electron microscopy. Clinical diagnostic showed normal value of epinephrine and norepinehrine in the urine. Scintigraphy of entire body and targeted pictures of pelvis where taken 24, 48 and 72 hours after administration of RI. No loci of pathologic accumulation of 131-I MIBG where found. Computer tomography (CT) of pelvis and abdomen were normal. Considering staging and pathohistological analysis, we treated our patient with TUR and longtime follow-up afterworth.

Abstract in Croatian

Tumori koji rastu unutar nadbubrežne žlijezde su feokromatocitomi; kada se nalaze ekstra-adrenalno, tada se zovu paragangliomi. Paragangliomi mokraćnog mjehura su vrlo rijetki, samo je 180 opisanih slučajeva u literaturi. Manje od 30 je maligno. U našem prikazu radi se o 72-godišnjem muškarcu, sa simptomima bezbolne hematurije. Učinjena je hitna transuretralna resekcija (TUR) mokraćnog mjehura. Konačna patohistološka dijagnoza postavljena je na osnovi imunohistokemije i elektronske mokroskopije. Dijagnostička obrada pokazala je normalne vrijednosti epinefrina i norepinefrina u urinu. Scintigrafija cijelog tijela i ciljane snimke zdjelice učinjene su 24, 48 i 72 sata nakon primjene radioaktinog joda (RI). Nije nađeno patološko nakupljanje kontrasta (131-I MIBG). Kompjuterizirana tomografija (CT) zdjelice i abdomena je bila uredna. Uzimajući u obzir stadij i patohistološku dijagnozu, mi smo se odlučili za TUR i dugoročno poslijeoperacijsko praćenje bolesnika.

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