Year: 2026
Type: article
Study design: Case Report
Abstract: Background Bladder paraganglioma is a rare non-epithelial neuroendocrine tumor. Catecholamine release may cause micturition-related headache, palpitations, sweating, paroxysmal hypertension, or syncope, but cases without typical symptoms can be difficult to recognize before surgery. Complete surgical excision remains the mainstay of treatment. Case presentation A 75-year-old woman was admitted after two bladder lesions were detected. She had no hematuria, lower urinary tract symptoms, or micturition-related headache, palpitations, sweating, or paroxysmal hypertension. Contrast-enhanced CT showed two hypervascular nodules near the bladder neck and on the left posterior wall, measuring 12 × 14 mm and 6 × 9 mm, respectively. Twenty-four-hour urinary free catecholamines were within the reference ranges. Plasma free normetanephrine was mildly elevated at 0.96 nmol/L (upper reference limit, 0.71 nmol/L; approximately 1.35 × ULN) when measured by LC-MS/MS under standardized sampling conditions, whereas plasma metanephrine and 3-methoxytyramine remained within their reference ranges. This profile was considered consistent with a clinically silent but mildly biochemically functional tumor. The patient underwent pneumovesicoscopic en bloc resection. Histopathology confirmed multifocal bladder paraganglioma confined to the submucosa, with negative surgical margins, a Ki-67 proliferation index <1%, and retained SDHB expression. Recovery was uneventful, and cystoscopy showed no recurrence at 12 months. Conclusions Bladder paraganglioma should be considered in a hypervascular submucosal bladder mass with intact overlying mucosa even when typical catecholamine-related symptoms are absent. This single case supports the technical feasibility of pneumovesicoscopic en bloc resection for selected localized lesions, but the 12-month follow-up is insufficient to establish comparative effectiveness or long-term oncologic safety.
Source: Frontiers in Medicine
Authors: Bing Wang, Yu Hong, Tianhai Liao, Dingli Hu, Yunlong Li
Institution: First People's Hospital of Kunshan
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funder: Nantong University
OpenAlex ID: W7223153227