Preoperative Diagnosis of Bladder Paraganglioma Followed by Robot-Assisted Partial Cystectomy: A Case Report.

Abstract

Introduction: Bladder paraganglioma is a rare neuroendocrine tumor for which accurate preoperative diagnosis is important because tumor manipulation may provoke catecholamine-related hemodynamic instability.

Case presentation: A 58-year-old man presented with hematuria. Cystoscopy revealed a submucosal bladder tumor. Contrast-enhanced computed tomography and magnetic resonance imaging demonstrated a 2-cm bladder wall mass with characteristic findings suggestive of paraganglioma. Although catecholamine levels were within normal limits and no adrenergic symptoms were present, metaiodobenzylguanidine scintigraphy showed uptake in the lesion, supporting the diagnosis. To avoid the potential risk associated with TUR, preoperative alpha-adrenergic blockade with doxazosin was administered, followed by robot-assisted partial cystectomy. No significant intraoperative hemodynamic instability occurred. Histopathological examination confirmed paraganglioma.

Conclusion: Recognition of characteristic imaging findings may facilitate preoperative diagnosis and safe surgical management of bladder paraganglioma. Robot-assisted partial cystectomy was a feasible minimally invasive treatment option.