前列腺原发性副神经节瘤：一种罕见实体的文献系统综述

Primary Paraganglioma of the Prostate: A Systematic Review of the Literature for A Rare Entity.

作者信息

Giannakodimos Ilias, Ziogou Afroditi, Giannakodimos Alexios, Mitakidi Evangelia, Tzelepis Konstantinos, Fragkiadis Evangelos, Charalampakis Nikolaos

机构信息

Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Department of Medical Oncology, Metaxa Cancer Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Rev Recent Clin Trials. 2024;19(3):189-195. doi: 10.2174/0115748871293735240209052044.

DOI:10.2174/0115748871293735240209052044

PMID:38549519

Abstract

BACKGROUND

Paragangliomas of the urinary tract are exceptionally uncommon, and sporadic case reports of primary paraganglioma of the prostate have been reported in the literature.

METHODS

Systematic research in PubMed/Medline and Scopus databases concerning primary prostatic paraganglioma was performed by two independent investigators.

RESULTS

This analysis included 25 adult males, with a mean age of 49.8 ± 22.4 years. 32% of included patients had a history of hypertension. Problems during urination (52%), blood loss (44%), either as hematuria or hemospermia, and catecholamine-related symptoms (36%) comprised the most frequently reported clinical manifestations. Digital rectal examination found a palpable nodule in 36% of patients, while prostatic specific antigen (PSA) was normal in all tested patients. Abdominal ultrasound (44%), computed tomography (44%) and magnetic resonance imaging (28%) helped to identify the primary lesion. 24-hour urine epinephrine, norepinephrine and vanillylmandelic acid (VMA) levels were elevated in 90%, 80% and 90% of included patients. Open surgical excision of the mass was performed in 40%, transurethral resection in 8%, open radical prostatectomy in 24%, transurethral resection of the prostate in 16% and robot-assisted radical prostatectomy in 4% of included patients.

CONCLUSION

Due to atypical clinical manifestation and scarcity of prostatic paraganglioma, urologists should be aware of this extremely rare entity.

摘要

背景

泌尿道副神经节瘤极为罕见，文献中已有前列腺原发性副神经节瘤的散发病例报道。

方法

两名独立研究人员对PubMed/Medline和Scopus数据库中有关原发性前列腺副神经节瘤进行了系统研究。

结果

该分析纳入25名成年男性，平均年龄为49.8±22.4岁。32%的纳入患者有高血压病史。排尿困难（52%）、失血（44%，表现为血尿或血精）以及儿茶酚胺相关症状（36%）是最常报道的临床表现。直肠指检发现36%的患者可触及结节，而所有接受检测的患者前列腺特异性抗原（PSA）均正常。腹部超声（44%）、计算机断层扫描（44%）和磁共振成像（28%）有助于识别原发病变。90%、80%和90%的纳入患者24小时尿肾上腺素、去甲肾上腺素和香草扁桃酸（VMA）水平升高。40%的纳入患者进行了肿块开放性手术切除，8%进行了经尿道切除术，24%进行了开放性根治性前列腺切除术，16%进行了经尿道前列腺切除术，4%进行了机器人辅助根治性前列腺切除术。