Non-Functional Paraganglioma of the Urinary Bladder: A Rare Cause of Bladder Tumor.

INTRODUCTION: Paragangliomas of the urinary bladder (PUBs) are rare neuroendocrine tumors, representing less than 0.06% of all bladder neoplasms. While most are functional and associated with catecholamine excess, approximately 15% are non-functional, often presenting asymptomatically and discovered incidentally. Due to their rarity, standardized management guidelines are lacking.

CASE PRESENTATION: We report a 57-year-old female evaluated for ureterolithiasis who was incidentally found to have a 1.5 cm posterior bladder lesion. Biopsy confirmed paraganglioma. Functional studies, including plasma and urinary metanephrines, were negative, establishing a non-functional tumor. DOTATATE PET/CT and genetic testing excluded metastasis and hereditary syndromes. At planned transurethral resection, no residual lesion was identified, and pathology was benign. The patient remains asymptomatic on follow-up.

CONCLUSION: This case illustrates the diagnostic challenges of non-functional PUBs and emphasizes the importance of multidisciplinary evaluation and vigilant follow-up in the absence of standardized management strategies.