Nonfunctioning paraganglioma of the bladder mimicking nested variant of urothelial cancer: A case report and clinical management.

INTRODUCTION AND

IMPORTANCE

Non-functioning paraganglioma of the bladder is extremely rare disease. It is important to know the presence of paraganglioma of the bladder as the early and correct diagnosis affects the management and prognosis of the patient. Pathologists may misinterpret it as part of cystitis cystica/glandularis or nested variant urothelial carcinoma, or secondary bladder involvement by prostatic adenocarcinoma. This report will contribute to the existing literature and provide valuable insights into the clinical characteristics and treatment options for this rare tumor.

PRESENTATION OF CASE: 35 years old female patient presented after incidental finding of bladder mass on abdominal ultrasound during routine antenatal follow up. Cystoscope showed 2 × 2 cm single solid bladder mass. Microscopic examination was suggestive of neuroendocrine tumor with paragangliom as a differential diagnosis. Imminohistochemical studies showed positive for synaptophysin, S100, GATA-3 and negative for panCK. The patient was managed with partial cystectomy.

CLINICAL DISCUSSION: Non-functioning paragnaglioma of the urinary bladder is a rare extra-adrenal pheochromocystoma. The diagnosis is usually challenging and it may mimic urothelial carcinoma. Histopathology and immunohistochemistry are almost always confirmatory.

CONCLUSION

Urinary bladder paraganglioma may mimic nested variant of the bladder tumor. High clinical suspicion is important. Confirmation is with histopathology and immunohistochemistry. Partial cystectomy is treatment of choice.