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Hooshyari A, Tyson M, Rice M. Paraganglioma (pheochromocytoma) of the urinary bladder: A systematic review with a diagnostic, management and treatment algorithm. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221090329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Paraganglioma of the urinary bladder is a rare but well-documented tumour. Herein, we provide the largest, comprehensive systematic review of the literature and aim to increase familiarity with this rare but significant neoplasm. Methods: A systematic review of the literature was conducted on the NCBI PubMed database. The search criteria were not limited to any specific years or languages. There were 418 articles between January 1953 and August 2020, of which 255 case reports were selected. Results: Paragangliomas of the urinary bladder most commonly occurred in Caucasians in the fifth decade of life, most commonly presenting with haematuria and variations of ‘micturition attacks’. Eighty percent of tumours were functionally active. The mucosa was normal in 91% of patients. In all, 25% of tumours were treated with transurethral resection alone, 65% had partial cystectomy and 5% had radical cystectomy. Alpha-blockers were administered pre-operatively in 38% of patients and the risk of intra-operative hypertensive crisis was over three times greater in those who did not receive an alpha-blocker. The tumour was confined to the bladder in 75% of cases. Metastasis occurred in 20% of cases, most commonly to iliac nodes. The mean follow-up time was 26.5 months. In cases that documented follow-up, 18.6% had recurrence, most commonly in lymph nodes and bone. Conclusion: All patients presenting with micturition attacks or haematuria with a computed tomography showing an enhancing, well-defined submucosal bladder lesion and/or cystoscopy showing a lesion with normal overlying mucosa should be worked up for a possible paraganglioma of the urinary bladder. Level of evidence: Not applicable
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Affiliation(s)
- Ali Hooshyari
- Urology Department, Auckland City Hospital, Auckland District Health Board, New Zealand
| | - Matthew Tyson
- Urology Department, Auckland City Hospital, Auckland District Health Board, New Zealand
| | - Michael Rice
- Urology Department, Auckland City Hospital, Auckland District Health Board, New Zealand
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Wang EY, Pak JS, Virk RK, Anderson CB, Healy KA, Lee JA, Benson MC, McKiernan JM. Bladder Preservation for Patients With Bladder Paragangliomas: Case Series and Review of the Literature. Urology 2020; 143:194-205. [PMID: 32437773 DOI: 10.1016/j.urology.2020.04.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 12/27/2022]
Abstract
Bladder paragangliomas are rare tumors, with no prospective studies or guidelines on the management of this disease. We present a case series of 6 patients managed with bladder preservation over a median follow-up period of 124 months. We also present a review of the recent literature on bladder paragangliomas. We aim to provide a timely synthesis of the recent evidence on bladder paragangliomas as changing paradigms necessitate individualized treatment.
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Affiliation(s)
- Elizabeth Y Wang
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY; Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
| | - Jamie S Pak
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Renu K Virk
- Department of Pathology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Christopher B Anderson
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Kelly A Healy
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - James A Lee
- Department of Surgery, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - Mitchell C Benson
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
| | - James M McKiernan
- Department of Urology, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY
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