Ko Andrew, Ezzeldin Obadah, Bezold Samuel, Bhargava Peeyush
Department of Radiology, University of Texas Medical Branch, Galveston, TX, 77555.
Radiol Case Rep. 2021 Jul 22;16(9):2763-2767. doi: 10.1016/j.radcr.2021.06.079. eCollection 2021 Sep.
Paragangliomas are extra-adrenal catecholamine-secreting neuroendocrine tumors that can present with adrenergic signs and symptoms. The urinary bladder is a rare location for a paraganglioma, and these tumors must be distinguished from other more common bladder neoplasms. In this case report, we discuss a 59 year-old woman who initially presented with tachycardia, palpitations, chest tightness, shortness of breath, and weight loss. Laboratory evaluation showed significantly elevated catecholamines in the plasma and urine. A CT (Computed Tomography) scan of the abdomen and pelvis revealed an enhancing mass arising from the urinary bladder and an enlarged right pelvic lymph node. A follow up Ga-68 DOTATATE PET/CT (Positron Emission Tomography and/or Computed Tomography) showed increased uptake in the primary bladder mass, right pelvic lymph node, numerous skeletal lesions, and pulmonary nodules, consistent with metastatic paraganglioma of the urinary bladder. This case report demonstrates the radiological findings of metastatic urinary bladder paraganglioma and highlights the importance of skull base to mid-thigh PET/CT using Ga-68 DOTATATE. It is crucial for the radiologist to be familiar with the characteristics of urinary bladder paragangliomas and identify these tumors on imaging to allow prompt initiation of surgical resection and/or systemic therapy.
副神经节瘤是肾上腺外分泌儿茶酚胺的神经内分泌肿瘤，可出现肾上腺素能体征和症状。膀胱是副神经节瘤的罕见发病部位，这些肿瘤必须与其他更常见的膀胱肿瘤相鉴别。在本病例报告中，我们讨论了一名59岁女性，她最初表现为心动过速、心悸、胸闷、气短和体重减轻。实验室检查显示血浆和尿液中的儿茶酚胺显著升高。腹部和盆腔CT（计算机断层扫描）扫描显示膀胱有一强化肿块及右侧盆腔淋巴结肿大。后续的Ga-68 DOTATATE PET/CT（正电子发射断层扫描和/或计算机断层扫描）显示原发膀胱肿块、右侧盆腔淋巴结、多处骨骼病变及肺结节摄取增加，符合膀胱转移性副神经节瘤。本病例报告展示了膀胱转移性副神经节瘤的影像学表现，并强调了使用Ga-68 DOTATATE进行从颅底到大腿中部PET/CT检查的重要性。放射科医生熟悉膀胱副神经节瘤的特征并在影像学上识别这些肿瘤以便及时启动手术切除和/或全身治疗至关重要。
