Peng Chuandu, Bu Siyuan, Xiong Shenghua, Wang Kunjie, Li Hong
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Oncol Lett. 2015 Jul;10(1):321-324. doi: 10.3892/ol.2015.3222. Epub 2015 May 18.
Paraganglioma, also termed extra-adrenal pheochromocytoma, may be observed at the base of the skull and neck as well as within the mediastinum and periaortic region. The clinical symptoms of paraganglioma of the urinary bladder include intermittent hypertensive attacks, micturition, headaches and palpitations due to high catecholamine levels; these types of paragangliomas are extremely rare. However, certain bladder paragangliomas do not present with any of these symptoms; thus, surgeons are not pre-warned on how to prepare for their resection. Surgery to remove pheochromocytomas may therefore result in an intraoperative hypertensive crisis and increase the mortality rate. This infrequent type of paraganglioma is only recognized through histological examination following surgery. The current study reports the case of a 61-year-old male with urinary bladder paraganglioma. The patient presented with hypertension, which was controlled to within a normal range using diovan and norvasc treatment; in addition, the patient's blood pressure was not altered with urination or postural changes. The patient was not administered an α-blocking agent or a blood volume expander prior to the surgery, and during the partial cystectomy no hypertensive crisis occurred.
副神经节瘤,也称为肾上腺外嗜铬细胞瘤,可出现在颅底、颈部以及纵隔和主动脉周围区域。膀胱副神经节瘤的临床症状包括由于高儿茶酚胺水平引起的间歇性高血压发作、排尿、头痛和心悸;这类副神经节瘤极为罕见。然而,某些膀胱副神经节瘤并无这些症状;因此,外科医生未提前得到如何为其切除做准备的警示。切除嗜铬细胞瘤的手术可能会导致术中高血压危象并增加死亡率。这种罕见类型的副神经节瘤仅在术后通过组织学检查才能确诊。本研究报告了一例61岁膀胱副神经节瘤男性患者的病例。该患者患有高血压,使用缬沙坦和氨氯地平治疗后血压控制在正常范围内;此外,患者排尿或体位改变时血压无变化。手术前未给患者使用α受体阻滞剂或血容量扩充剂,部分膀胱切除术中也未发生高血压危象。