Zhao Yi, Zhang Zhijun, Wang ShiJun, Wen Jin, Wang Dong, Ji ZhiGang, Zhang YuShi, Li HanZhong
Institution of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Surg. 2024 Apr 5;11:1348737. doi: 10.3389/fsurg.2024.1348737. eCollection 2024.
To review and summarize the characteristics and therapy of paraganglioma of the urinary bladder (PUB).
Patients who underwent the operation in Peking Union Medical College Hospital between January 2012 and December 2021 were reviewed for this retrospective study.
A total of 29 patients, comprising 9 (31%) men and 20 (69%) women, were included. The main manifestations were hypertension, palpitation, and micturition syncope. Eight patients had an increased 24-h urinary catecholamine, and seven of them had increased norepinephrine. Normetanephrine in seven patients was increased. Six of 18 metaiodobenzylguanidine and 8 of 22 octreotide scans were positive. In total, 15 cases underwent laparoscopic partial cystectomy and 14 underwent transurethral resection of bladder tumor. In all patients, the immunohistochemical index of Melan-A, AE1/AE3, and α-inhibin were negative, and chromogranin A, S-100, and succinate dehydrogenase were positive. The Ki-67 of 28/29 cases was under 5%, and 1 case with a Ki-67 of 20% was diagnosed with malignant PUB. A total of 27 patients had a regular follow-up, 2 patients were lost during the follow-up, 3 patients had a recurrence, and 1 of these patients died within 1 year of surgery. The symptoms all disappeared or were relieved after the surgery.
The transurethral surgery approach fits PUB tumors with a size <3 cm or that protrudes into the bladder and can significantly reduce the postoperative hospital stay. Early detection and treatment are effective, and regular review is necessary after the surgery.
回顾并总结膀胱副神经节瘤（PUB）的特点及治疗方法。
对2012年1月至2021年12月在北京协和医院接受手术的患者进行回顾性研究。
共纳入29例患者，其中男性9例（31%），女性20例（69%）。主要表现为高血压、心悸和排尿性晕厥。8例患者24小时尿儿茶酚胺升高，其中7例去甲肾上腺素升高。7例患者的去甲变肾上腺素升高。18例间碘苄胍扫描中有6例阳性，22例奥曲肽扫描中有8例阳性。总共15例行腹腔镜部分膀胱切除术，14例行经尿道膀胱肿瘤切除术。所有患者中，Melan-A、AE1/AE3和α-抑制素的免疫组化指标均为阴性，嗜铬粒蛋白A、S-100和琥珀酸脱氢酶为阳性。28/29例患者的Ki-67低于5%，1例Ki-67为20%的患者被诊断为恶性PUB。共有27例患者进行了定期随访，2例在随访期间失访，3例复发，其中1例在术后1年内死亡。术后症状均消失或缓解。
经尿道手术方法适用于直径<3 cm或突入膀胱的PUB肿瘤，可显著缩短术后住院时间。早期发现和治疗有效，术后需定期复查。
