Introduction. Paragangliomas, also known as chromaffin tumours, are rare neuroendocrine neoplasms arising from paraganglionic tissue located at various sites in the body. These tumours can be either benign or malignant (up to 10% of cases) and their clinical manifestation is often associated with functional activity that may result in the release of catecholamines into the bloodstream. Paragangliomas are most commonly found in the adrenal glands, but can also localise to the bladder region. According to current concepts, this disease develops from embryonic remnants of chromaffin cells located in the sympathetic plexus of the detrusor. Approximately 10% of such tumours are characterised by malignant potential. The present article presents a description of a clinical case of bladder paraganglioma, which demonstrates the stages of diagnosis, determination of treatment tactics and further dynamic follow-up of patients.
Materials and Methods. A detailed description of a clinical case of bladder paraganglioma in a 74-year-old female patient on the basis of the State Budgetary Institution "Moscow Clinical Research Center Hospital 52 of Moscow Healthcare Department" was carried out. The study included a comprehensive analysis of clinical and anamnestic data, results of laboratory and instrumental examination and pathohistological examination. Diagnostic methods were: clinical examination, instrumental and morphological methods of research.
Clinical case. Patient S. 74 years old came for emergency indications due to difficult urination, blood in the urine. From anamnesis it is known that during the last 6 months she started to notice difficult urination. It was also found out during questioning that there was a crisis course of arterial hypertension. In the course of additional examination a volumetric bladder mass was diagnosed in the area of the right bladder orifice, dilation of the upper urinary tract on the right side. Cystoscopy and transurethral resection of the bladder mass were performed for diatherapeutic purposes. According to the results of morphological examination, the data for bladder paraganglioma were obtained.
Conclusion. In a patient with crisis course of arterial hypertension, macrohaematuria, lower urinary tract symptoms it is possible to assume bladder paraganglioma as a differential diagnosis. The inconsistency of diagnostic standards and standards of treatment tactics, the difference of opinion on the efficacy of different methods, which vary from region to region and from medical institution to medical institution, emphasises the need to develop unified protocols for the diagnosis and treatment of bladder paraganglioma.
