Pichler Renate, Heidegger Isabel, Klinglmair Gerald, Kroiss Alexander, Uprimny Christian, Gasser Rudolf Wolfgang, Schäfer Georg, Steiner Hannes
Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
Urol Int. 2014;92(4):482-7. doi: 10.1159/000348829. Epub 2013 May 28.
Extra-adrenal paraganglioma with isolated localization in the urinary bladder is a rare neuroendocrine tumor. Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine due to headache for the past 8 years. As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup. After diagnosis of an extra-adrenal paraganglioma, the patient was scheduled for open partial cystectomy. In consideration of the fact that bladder paraganglioma is an infrequent genitourinary cancer, this case report clearly points out the importance of an exact anamnesis and clinical examination to minimize the probability of misdiagnosis with possible fatal consequences in any case with clinical suspicion of bladder paraganglioma.
膀胱孤立性肾上腺外副神经节瘤是一种罕见的神经内分泌肿瘤。尽管诸如头痛、恶心、体重减轻、潮红、心悸或排尿时阵发性高血压等典型症状已为人熟知，但我们报告了一例不寻常的膀胱副神经节瘤病例，该病例因头痛在过去8年中被“误诊”为基底型偏头痛。由于泌尿科医生通过CT发现了肿瘤并将其与排尿相关症状联系起来，因此在进行详细诊断检查之前未进行膀胱镜检查和经尿道膀胱切除术。在诊断为肾上腺外副神经节瘤后，患者被安排进行开放性膀胱部分切除术。鉴于膀胱副神经节瘤是一种罕见的泌尿生殖系统癌症，本病例报告明确指出了准确病史采集和临床检查的重要性，以便在任何临床怀疑膀胱副神经节瘤的病例中尽量减少误诊的可能性，因为误诊可能会带来致命后果。
