Rare Case Report of Urinary Bladder Paraganglioma: Lessons for Clinicians

Abstract

Background: Paraganglioma of the urinary bladder is a rare neuroendocrine tumor arising from chromaffin cells within the bladder wall. When functional, it may secrete catecholamines and present with characteristic symptoms such as hypertension, headache, palpitations, and sweating, which can be triggered by micturition or bladder distension. Case Presentation: Our patient, a 45-year-old male presented to the urology clinic with a 6-month history of intermittent episodes of severe headaches, palpitations, and profuse sweating immediately following micturition. Urinanalysis revealed a microscopic hematuria and ultrasound demonstrated a mass on the left lateral wall of the bladder. Elevated levels of 24-hour urinary fractionated metanephrines and normetanephrines confirmed the suspicion of a catecholamine-secreting tumor; A premedication with alpha-adrenergic blockade was started, then the patient was subjected to transurethral resection with complete excision of the mass. Histopathological examination came out to be paraganglioma. Conclusion: Paraganglioma of the urinary bladder, though rare, must be considered in the differential diagnosis of paroxysmal hypertension, especially when symptoms are related to micturition. Successful management requires a multidisciplinary approach involving urology, endocrinology, and anesthesiology, with rigorous preoperative alpha-blockade being the most critical step for a safe surgical outcome. Our patient remains disease-free and normotensive at 12-month follow-up.