Paraganglioma of the Urinary Bladder: A Case Report and Review of Literature

Paraganglioma of the urinary bladder is a rare tumour with characteristic histopathological and immunehistochemical features. It is difficult to differentiate the tumour as benign or malignant based on the histological findings alone. Recognition of this tumour is important for the proper management of these patients, as these patients may or may not be having bothersome symptoms. Extra adrenal pheochromocytomas are known as paragangliomas. Majority of these Extra adrenal tumours occur intraabdominally along the sympathetic chain. These tumours of the sympathetic nervous tissue may be non-functional or functional and when they secrete catecholamine, they cause paroxysmal hypertension, palpitation, and micturition syncope. The current report presents a case of a 36 year old male, who was suffering from recurrent dysuria and vague supra pubic discomfort for the past six months. Clinical evaluation and imaging were normal. Cystoscopy revealed a small sessile polyp over the dome of the bladder. Histopathology showed the characteristic ‘zellballen' pattern which was confirmed by immunohistochemical staining. The purpose of this case report is to highlight the rarity of the tumour, the various unusual modes of presentation and to stress on the need to forewarn the surgeons and the anaesthetists of the possible intra-operative hypertensive crisis during resection of such tumours.