Diagnosis and treatment of micro-paragangliomas in urinary bladdler
10.3969/j.issn.1001-6325.2017.11.023
- VernacularTitle:微小膀胱副神经节瘤的诊治分析
- Author:
hua Guang LIU
1
;
feng Wei XU
;
Yi XIE
;
bing Bing SHI
;
shi Yu ZHANG
;
zhong Han LI
;
gang Zhi JI
Author Information
1. 中国医学科学院北京协和医学院北京协和医院泌尿外科
- Keywords:
paraganglioma;
bladder neoplasm;
transurethral resection
- From:
Basic & Clinical Medicine
2017;37(11):1615-1619
- CountryChina
- Language:Chinese
-
Abstract:
Objective To develope the diagnostic criteria and surgical methods to treat micro-paraganagliomas (<1 cm) of urinary bladder ( PUB) , we now report a case series study including 5 individual cases .Methods Clinical data of 5 patients with micro-PUBs who underwent surgical treatment were obtained and analyzed retrospectively . Two male patients and three female patients were included in our study with the mean age of 51 ( range from 41 to 65 years) .4 patients were reported as symptomatic due to hypercatecholaminemia , while the other was free of symptoms.24-hour urine catecholamine ( CA) examination was utilized to qualitatively diagnose PUB , positive in 75%patients.Ultrasonography(USG), CT, MRI, 111In-DTPA-Octreotide scintigraphy (OctreoScan) and 131 I-MIBG scintigraphy were used to locate the tumor , positive in 80%, 20%, 75%, 25%and 33%patients respectively .What's more, all 5 patients underwent transurethral resection of tumor .Overfilling of bladder and puncture following ultra-sonography guidance were performed to locate the tumors , when tumors were absent in surgical vision .Results All tumors were located and resected completely with no open conversions .It took 0.5 to 26 minutes to locate the tumor and another 3 to 10 minutes to resect the tumors .All lesions were diagnosed by histopathological confirma-tion, especially by immunohistochemical staining.Blood pressure return to normal level after the procedures.No local recurrence or distal metastasis were observed by performing 24-hour urine CA test , USG, cystoscopy and MRI within adequate follow-up.The mean follow-up duration was 38.6 months, ranging from 6 to 120 months.Conclu-sions USG and MRI examination were considered better in detecting micro PUB than CT-scan.Overfilling of blad-der and puncture following USG guidance may support more accurate tumor location intraoperatively if the tumors were not found in transurethral resection procedures .
