Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan.
Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan.
BMC Urol. 2023 Feb 17;23(1):21. doi: 10.1186/s12894-023-01185-x.
Paraganglioma of genitourinary tract is uncommon, and origin from ureter is even rarer. We aim to present a case of paraganglioma from ureter in a 48-year-old female patient, who presented with gross hematuria.
We present a 48-year-old female who complained of gross hematuria for one week. A left ureteral tumor was found by image study. However, hypertension was unexpectedly recorded during diagnostic ureteroscopy survey. Due to persisted gross hematuria and bladder tamponade, she underwent left nephroureterectomy with bladder cuff resection. Blood pressure surged again when the tumor was surgically approached. Ureteral paraganglioma was confirmed according to pathological report. After the surgery, the patient recovered well, and no more gross hematuria was noted. She is now under regular follow-up at our outpatient clinic.
Ureteral paraganglioma should be kept in mind not only when blood pressure fluctuates during operation, but also before we manipulate the ureteral tumor when gross hematuria is the only sign. Whenever the presumption of paraganglioma is raised, laboratory evaluation and anatomical or even functional imaging should be considered. The concomitant anesthesia consultation before the surgery should not be deferred, either.
泌尿生殖道的副神经节瘤并不常见，起源于输尿管的则更为罕见。我们旨在报告一例 48 岁女性输尿管副神经节瘤病例，该患者因肉眼血尿就诊。
我们报告了一例 48 岁女性，因肉眼血尿 1 周就诊。影像学研究发现左侧输尿管肿瘤。然而，在诊断性输尿管镜检查过程中意外记录到高血压。由于持续存在肉眼血尿和膀胱填塞，患者接受了左肾输尿管切除术和膀胱袖套切除术。当肿瘤被手术接近时，血压再次飙升。根据病理报告证实为输尿管副神经节瘤。手术后，患者恢复良好，未再出现肉眼血尿。她现在在我们的门诊定期随访。
不仅在手术过程中血压波动时，而且在仅出现肉眼血尿时处理输尿管肿瘤之前，都应牢记输尿管副神经节瘤。只要怀疑为副神经节瘤，就应考虑实验室评估以及解剖学甚至功能影像学检查。术前也不应延迟麻醉咨询。
