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[膀胱副神经节瘤]

[Multiple paraganglioma of the urinary bladder].

作者信息

Kita Masafumi, Okuyama Mitsuhiko, Azumi Makoto, Hashimoto Hiroshi, Kakizaki Hidehiro

机构信息

Department of Urology, Asahikawa Medical College.

出版信息

Hinyokika Kiyo. 2007 Oct;53(10):707-11.

Abstract

A 77-year-old woman who was treated for malignant melanoma was incidentally found to have a bladder tumor on a screening computed tomography (CT). On CT and magnetic resonance imaging (MRI), the tumor was detected as a well-enhanced tumor (4 x 5 cm at horizontal plane) on the left side of the bladder wall. Cystoscopy revealed a small non-papillary pedunculated tumor on the posterior wall and a submucosal tumor on the left side of the wall. We performed transurethral resection of the tumor on the posterior wall and biopsy of the tumor on the left side wall. The pathological diagnosis was paraganglioma of the urinary bladder. Serum and urine levels of noradrenaline and dopamine were elevated. 123I-metaiodobenzylguanidine (MIBG) scintigraphy showed a significant uptake on the left side of the bladder. Blood pressure was normal at rest but elevated after micturition. No pelvic lymph node swelling or distant metastasis was detected. We performed partial cystectomy for the tumor on the left side wall. After operation, serum catecholamine level was normalized and post-voiding fatigue that was present before operation disappeared. Six months after operation, a followup CT revealed a small well-enhanced tumor on the anterior wall of the bladder. Her serum noradrenaline level was slightly elevated. However, she was normotensive and had no symptoms. Therefore, a careful follow-up continued for 2 years there after has revealed no increase in tumor size and no symptoms.

摘要

一名接受恶性黑色素瘤治疗的77岁女性在计算机断层扫描(CT)筛查时偶然发现患有膀胱肿瘤。在CT和磁共振成像(MRI)上,肿瘤表现为膀胱壁左侧一个强化良好的肿瘤(水平面大小为4×5厘米)。膀胱镜检查发现后壁有一个小的无蒂带蒂肿瘤和左侧壁有一个黏膜下肿瘤。我们对后壁肿瘤进行了经尿道切除术,并对左侧壁肿瘤进行了活检。病理诊断为膀胱副神经节瘤。血清和尿液中的去甲肾上腺素和多巴胺水平升高。123I-间碘苄胍(MIBG)闪烁显像显示膀胱左侧有明显摄取。静息时血压正常,但排尿后升高。未检测到盆腔淋巴结肿大或远处转移。我们对左侧壁肿瘤进行了膀胱部分切除术。术后,血清儿茶酚胺水平恢复正常,术前存在的排尿后疲劳消失。术后6个月,随访CT显示膀胱前壁有一个小的强化良好的肿瘤。她的血清去甲肾上腺素水平略有升高。然而,她血压正常且无症状。因此,此后进行了2年的密切随访,未发现肿瘤大小增加及任何症状。

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