Quist Erin E, Javadzadeh Barry M, Johannesen Eric, Johansson Sonny L, Lele Subodh M, Kozel Jessica A
University of Nebraska Medical Center, Department of Pathology and Microbiology, 983135 Nebraska Medical Center, Omaha, NE 68198-3135, USA.
CHI Health, Midwest Pathology Specialists, 6901N, 72nd Street, Omaha, NE 68122, USA.
Pathol Res Pract. 2015 Feb;211(2):183-8. doi: 10.1016/j.prp.2014.10.009. Epub 2014 Nov 27.
Although paragangliomas of the bladder are uncommon, malignant paragangliomas of this anatomic site are exceedingly rare, with a mere 37 previously reported cases. We report the case of a 58-year-old man with a malignant paraganglioma of the bladder who sought care secondary to gross hematuria; however, misdiagnosis of this tumor resulted in hypertensive crisis during cystoprostatectomy. Not only does this case present a unique malignant paraganglioma of the bladder, but also it discusses the clinical ramifications when misdiagnosed. Like pheochromocytomas, extra-adrenal paragangliomas can manifest with similar sympathetic stimulation; this becomes a serious complication for clinicians resecting these tumors in unusual locations without proper histologic diagnosis. Additionally, we discuss the unique clinical and pathologic findings of our patient and comprehensively review the previously published cases comparing clinical and pathologic features. Several interesting findings are identified including average age at diagnosis, gender predilection, presenting symptoms, size at diagnosis, and common sites of metastasis.
尽管膀胱副神经节瘤并不常见，但该解剖部位的恶性副神经节瘤极为罕见，此前仅有37例报道。我们报告了一例58岁男性膀胱恶性副神经节瘤患者，该患者因肉眼血尿就诊；然而，该肿瘤的误诊导致了膀胱前列腺切除术中的高血压危象。该病例不仅呈现了一种独特的膀胱恶性副神经节瘤，还探讨了误诊时的临床后果。与嗜铬细胞瘤一样，肾上腺外副神经节瘤可表现出类似的交感神经刺激症状；对于在未进行适当组织学诊断的情况下在不寻常部位切除这些肿瘤的临床医生来说，这会成为一个严重的并发症。此外，我们讨论了我们患者独特的临床和病理发现，并全面回顾了先前发表的病例，比较了临床和病理特征。确定了几个有趣的发现，包括诊断时的平均年龄、性别偏好、出现的症状、诊断时的大小以及常见转移部位。
