Case Report

Journal of Zhejiang University SCIENCE B

, Volume 8, Issue 6, pp 435-438

Diagnosis and treatment of pheochromocytoma in urinary bladder

  • Liu Yong Affiliated withDepartment of Urology, Affiliated Hospital, School of Medicine, Qingdao University
  • , Dong Sheng-guo Affiliated withDepartment of Urology, Affiliated Hospital, School of Medicine, Qingdao University
  • , Dong Zhen Affiliated withDepartment of Urology, Affiliated Hospital, School of Medicine, Qingdao University
  • , Mao Xin Affiliated withDepartment of Urology, Affiliated Hospital, School of Medicine, Qingdao University
  • , Shi Xin-yan Affiliated withDepartment of Urology, Affiliated Hospital, School of Medicine, Qingdao University

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Abstract

Objective

To study the diagnosis and treatment of pheochromocytoma in urinary bladder.

Methods

Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine (CA) was increased in a case, and vanillymandelic acid (VMA) was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5), computerized tomography (CT) in 3 cases (3/3), cystoscopy in 5 cases (5/6). Four cases took α-receptor blocker for 2 weeks, 1 case took β-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations.

Results

Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma postoperatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy.

Conclusions

Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, 131I-MIBG (methyliodobenzylguanidine) and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.

Key words

Urinary bladder Pheochromocytoma Diagnosis Therapeutics

CLC number

R69