Non-functional bladder paraganglioma in a young patient: conservative management by transurethral resection and diagnostic challenges

TL;DR

A rare non-functional bladder tumor was successfully treated with surgery, highlighting the challenges in diagnosing and managing such cases.

Contribution

This case report highlights the diagnostic and management challenges of non-functional bladder paraganglioma.

Findings

Transurethral resection was effective for treating the non-functional bladder paraganglioma.

Histological and immunohistochemical analysis confirmed the diagnosis and ruled out urothelial carcinoma.

Prolonged surveillance is necessary due to the risk of recurrence or malignant transformation.

Abstract

Bladder paraganglioma is a rare neuroendocrine tumor, accounting for less than 0.05% of all bladder tumours. Its clinical presentation is often variable, making diagnosis challenging, particularly in non-functional forms. We report the case of a patient with a bladder paraganglioma revealed by recurrent haematuria, in the absence of clinical signs of catecholamine secretion. Transurethral resection enabled complete treatment, although the procedure was complicated by stimulation of the obturator nerve, without a notable incident. Postoperative investigations, including follow-up cystoscopy and urinary metanephrine levels, were unremarkable. This case illustrates the diagnostic challenges associated with non-secretory forms. The diagnosis was confirmed by histological and immunohistochemical analysis, which ruled out urothelial carcinoma. Treatment is based on complete resection, and prolonged surveillance is warranted due to the rare but real risk of recurrence or malignant transformation. Although rare, bladder paraganglioma should be considered in the presence of any atypical bladder mass. Appropriate management and close follow-up are essential to ensure an excellent prognosis.

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