PTU - Polskie Towarzystwo Urologiczne
list of articles:

PHEOCHROMOCYTOMA OF THE URINARY BLADDER
Article published in Urologia Polska 2000/53/2.

authors

Zygmunt Dobrowolski 1, Wac³aw Lipczyński 1, Jerzy Bucki 2, Jerzy Stachura 3, Barbara Postawa 4
1 Klinika Urologii CM UJ
Kierownik: dr hab. med. Z. Dobrowolski
2 I Klinika Chirurgii CM UJ
Kierownik: prof. dr hab. med. T. Popiel±
3 Katedra Patomorfologii CM UJ
Kierownik: prof. dr hab. med. J. Stachura
4 Klinika Chorób Zaka¼nych CM UJ
Kierownik: prof. dr hab. med. J. Caban

keywords

urinary bladder ? pheochromocytoma

summary

Objective. Pheochromocytoma is an uncommon neoplasm found in 0,1% of
all patients with hypertension. Extraadrenal pheochromocytomy occurs in 18%
of all cases of this neoplasm, 1 % of which is located in the urinary bladder.
Patients and methods. The paper presents the case of a 33-year old male patient
with chromaffin T4a, N1 M1m tumour paraganglioma ~ pheochromocytomy in the
urinary bladder, diagnosed and treated initially as tumour of urinary bladder (in
histopathological examination - cystitis glandularis partim ulcerosa). At that time
there were no characteristic symptoms of chromaffin tumour, such as headaches,
palpitation, raised blood pressure after miction with the filling of tiredness. The
course of the disease was slow, characteristic symptoms appeared late with very
fast local progression infiltration filling the light of the bladder with the occupation
of the left ostium of ureter by the infiltration, of the left prostate lobe and left
spermate follicule, left external iliac yessels. The diagnosis was made of the basis
of history data, usg, urography, cystoscopy, Computer tomography, scintigraphy
and biopsy. The image examinations did not give possibility of determining the
original point of departure of the neoplasm. After endocrynological Preparation
ablation of urinary bladder, prostate, seminal vesicle and part of the left ureter
with bilateral ureterosigmoid anastomosis, lymphadenectomy of pelvis, ablation
of the left external iliac yessels with their subsequent replacement with a prothesis
was performed. In the postoperative course haemodynamic and methabolic high
degree disturbances occurred, complicated by pneumonia and insufficiency of
kidneys and finally multiorgan insufficiency which led to failure of treatment.
Conclusion. In case of vesical pheochromocytoma the poor prognostic factors
are: young patient, Calcified tumour, and it's rapid growth thru infiltration of
surrounding tissues.

references

  1. [1] Asbury W.?L.Jr., Hatcher, P. A., Gould, H. R., Reeves, W. A., Wilson,
  2. D. D.: Bladder pheochromocytoma with ring calcification. Abdom. Imagin. 1996,
  3. 21, 275-277.
  4. [2] Fujishima, S., Abe, I., Kaseda, S., Koga, T., Hirano, H., Hamada, T.,
  5. Oniki, H., Onoyama, K., Fujishima, M.: Ambidatory blood pressure monito-
  6. ring in diagnosing a pheochromocytoma of the urinary bladder. A case report. An-
  7. giology 1997, 48, 655-658.
  8. [3] Jorge, A. A., Lucon, A. M., Bloise, W., Mendonca, B. B.: Pheochromocy-
  9. toma of the urinary bladder, report of a case and review of the literature. Rev. Hosp.
  10. Clin. Fac. Med. ¦ao Paulo 1997, 52, 28-31.
  11. [4] Lee, S. R, Wang, G. G., Hwang, S. C, Chen, M. T., Lin, H. D.: Pheochro-
  12. mocytoma of the urinary bladder a case report. Chung Hua I Hsueh. Tsa. Chih.,
  13. Taipei 1996, 57, 297-300.
  14. [5] Murphy, W.: Diseases of the urinary bladder in Urological "Pathology" by Saun-
  15. ders Company. 1997, Chap. 2,107-110.
  16. [6] Piedrola, G., Lopez, E., Rueda, M. D., Lopez, R., Serrano, ]., Sancho,
  17. M.: Malignant pheochromocytoma of the bladder: current controversies. Eur. Urol.
  18. 1997, 31,122-125.