Clinicopathological characteristics and diagnostic strategies of prostatic paraganglioma presenting with prostatic mass and micturition-associated symptoms
10.12483/j.issn.1009-8291.2026.06.009
- VernacularTitle:以前列腺占位伴排尿相关症状为特征的前列腺副神经节瘤诊治分析
- Author:
Mengjie ZHANG
1
;
Qun LU
1
;
Yao FU
2
;
Qing ZHANG
1
;
Weidong GAN
1
;
Hongqian GUO
1
Author Information
1. Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210000; Institute of Urology Nanjing University, Nanjing 210000
2. Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210000, China
- Publication Type:Journal Article
- Keywords:
prostatic paraganglioma;
pheochromocytoma;
catecholamine;
post-micturition palpitations;
robot-assisted surgery
- From:
Journal of Modern Urology
2026;31(6):552-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical characteristics, diagnostic reasoning, and therapeutic strategies of prostatic paraganglioma (PPG) to provide an evidence-based foundation for early diagnosis and precision treatment of this rare malignancy. Methods The clinical data of a patient with PPG admitted to our hospital were retrospectively analyzed. Concurrently, a systematic search was conducted across domestic and international databases, including PubMed, CNKI, and Wanfang.Clinical manifestations, laboratory tests, pathological features, therapeutic modalities, and prognostic data of 24 cases reported between 1979 and 2025 were pooled with the institutional case for a comprehensive analysis (n=25). Results Epidemiological features: the age at onset ranged from 8 to 76 years, with a mean age of (44.6±15.2) years, predominantly affecting young and middle-aged adults (30-50 years).Notably, 20.0% (5/25) of the patients exhibited characteristic micturition-associated catecholamine release symptoms (e.g., post-micturition palpitations, transient hypertension).Laboratory findings: among the 19 patients who underwent catecholamine metabolite testing, 14 (73.7%) showed significant elevation in serum or urinary norepinephrine and methoxyadrenaline levels.Pathological and immunohistochemical features: the positivity rate for neuroendocrine markers (chromogranin A, synaptophysin, and neuron-specific enolase) was 100%, while the negativity rate for prostate-specific markers (prostate-specific antigen and prostate-specific acid phosphatase) was also 100%.Treatment and prognosis: surgical intervention was performed in 96.0% (24/25) of the patients, including radical prostatectomy (37.5%), precision tumor excision (25.0%), and transurethral resection (12.5%).Favorable outcomes without recurrence were observed in 89.5% (17/19) of the total cohort. Conclusion PPG is clinically exceedingly rare.The disease should be highly suspected in patients presenting with a prostatic mass, normal prostate-specific antigen level, and micturition-associated cardiovascular symptoms.Testing for catecholamine metabolites is the key screening tool.Robot-assisted surgery facilitates precise tumor excision while ensuring optimal functional preservation.Given the malignant potential and genetic correlations of PPG, lifelong follow-up is recommended.
