Bladder-Phæochromocytoma Metastases

Yoffa, DavidE.; Withycombe, J. F. R.

doi:10.1016/s0140-6736(67)92045-4

Cited by 22 publications

(6 citation statements)

References 7 publications

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“…However, no defined histological features exist to safely distinguish benign and malignant pheochromocytomas. Yoffa and Withycombe [6] reported a patient who had a 35-year history of pheochromocytoma of the urinary bladder before partial cystectomy, and metastases developed in the right iliac and obturator lymph nodes 8 years after partial cystectomy. Kato et al [7] reported malignant pheochromocytoma metastasized 31 years after partial cystectomy.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Cystectomy of a Bladder Pheochromocytoma

Kang

Kang²,

Choi³

et al. 2011

Urol Int

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Pheochromocytoma of the urinary bladder is an unusual tumor that typically presents with hypertensive crises related to micturition. We report here an unusual case of bladder pheochromocytoma that was treated by robotic-assisted laparoscopic partial cystectomy. A 35-year-old male patient presented with headache and hypertension related to micturition. The patient, who had a 3.5 × 4 cm solitary bladder tumor in the bladder dome, underwent robot-assisted partial cystectomy. The whole procedure was successfully performed using the robot without conversion to open surgery. The total operative time was 120 min and the estimated blood loss was 30 ml.

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Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Cystectomy of a Bladder Pheochromocytoma

Kang

Kang²,

Choi³

et al. 2011

Urol Int

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“…The first case of paraganglioma (pheochromocytoma) of the urinary bladder was reported by Zimmerman et al in 1953 1. The authors indicated that “its (paraganglioma) obvious capacity to invade justified its classification as a malignant tumor, and yet the absence of mitoses and lack of cellular dissociation suggest a relatively benign course.”1 Since then, isolated case reports of malignant paraganglioma of the urinary bladder have appeared in the literature published in English 2–21. It is difficult to predict the biologic behavior of paraganglioma on morphologic grounds.…”

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confidence: 99%

Paraganglioma of the urinary bladder

Liu

Leibovich

Cheville

et al. 2000

Cancer

109

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BACKGROUND Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome. METHODS The Mayo Clinic experience over 53 years with paraganglioma of the bladder was reviewed. All histologic slides from 16 patients were reviewed by the authors. Eight cases were examined immunohistochemically with cytokeratin (AE1/3, cytokeratin 7, and cytokeratin 20), vimentin, S‐100 protein, neuroendocrine markers (chromogranin, synaptophysin, and neuron specific enolase), p53 protein, and MIB‐1. DNA ploidy was determined by digital image analysis in formalin fixed, paraffin embedded tissue. The mean follow‐up was 6.3 years (range, 0.4–16.4 years). RESULTS Paraganglioma usually occurred in young adult women (mean age, 45 years; range, 16–74 years). The male‐to‐female ratio was 1 to 3. The common symptoms and signs were hypertension and hematuria. The tumors were usually located intramurally in the lateral and posterior wall of the bladder and were multifocal in 3 cases (18%). Seven patients were treated by transurethral resection, eight by partial cystectomy, and one by radical cystectomy. T classification was T1 (1 patient), T2 (9 patients), T3 (2 patients), and T4b (4 patients). At the time of diagnosis, one patient had distant metastasis and one had regional lymph node metastasis. One patient developed metastasis 1 year after diagnosis and died of the disease 1.5 years later. None of the patients with T1 or T2 tumors had recurrence or tumor progression. All tumors were aneuploid. The mean MIB‐1 labeling index was 1.5% (range, 0.03–7.0%). The tumor cells displayed immunoreactivity for S‐100 protein and neuroendocrine markers and were negative for p53 (except 1 case) and cytokeratin. CONCLUSIONS Paraganglioma of the urinary bladder occurs mostly in young adult women. Patients with tumor of advanced classification (≥T3) are at risk of recurrence, metastasis, and dying of the disease, whereas patients in this study with T1 or T2 disease had favorable outcomes after complete tumor resection. Cancer 2000;88:844–52. © 2000 American Cancer Society.

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“…Pang and Tsao 1 reported that 5–10% of pheochromocytomas are malignant, and that the prognosis is poor because of widespread metastases. Yoffa and Withycombe 14 reported a patient who had a 35‐year history of pheochromocytoma of the urinary bladder before partial cystectomy; metastases developed in the right iliac and obturator lymph nodes 8 years after partial cystectomy. Two of the present three cases’ tumors were malignant, therefore, pheochromocytomas of the urinary bladder may be more malignant.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological study of pheochromocytoma of the urinary bladder: Immunohistochemical, flow cytometric and ultrastructural findings with review of the literature

Kato

Suzuki

Mukai³

et al. 1999

Pathology International

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Pheochromocytomas usually arise from the adrenal medulla but may also arise from the carotid body, the retroperitoneum, the urinary bladder, and other locations. We report three cases of pheochromocytoma of the urinary bladder with clinicopathological, immunohistochemical, flow cytometric, and ultrastructural findings. Case 1, a 13-year-old boy presented with hematuria. He underwent partial cystectomy, 31 years later he presented with a tumor in the thoracic vertebra. Case 2, a 35-year-old woman presented with headache, nausea, vomiting, palpitations, and diaphoresis on evacuation. She underwent total cystectomy and regional lymph adenectomy. She survived for 10 years without recurrence or metastasis; however, she died from another disease. Case 3, a 31-year-old man presented with dysuria. He underwent total cystectomy and regional lymph adenectomy. The tumor metastasized to the lymph nodes, and the patient died after 4 years. The urinary bladder tumors in these three cases protruded into the lumen and invaded deeper than the middle of the muscle layer. The tumor of the urinary bladder, metastatic lymph nodes, and thoracic vertebra showed alveolar and trabecular patterns, and tumor cells were surrounded by capillaries. The tumor cells were moderate in size with ovoid nuclei and abundant eosinophilic cytoplasm that contained acidophilic granules reactive to Grimelius stain. Vascular invasion was observed in cases 1 and 2. Immunohistochemically, tumor cells showed reactivity for chromogranin, Leu 7, and S-100 protein. In each of the three cases, the DNA ploidy pattern on flow cytometry was aneuploid. Ultrastructural examination revealed several neurosecretory granules, rough endoplasmic reticulum, and a few mitochondria within the cytoplasm. It is difficult to determine whether pheochromocytoma of the urinary bladder is malignant on the basis of histological, immunohistochemical, and flow cytometric findings. Long-term follow up is necessary.

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Bladder-Phæochromocytoma Metastases

Cited by 22 publications

References 7 publications

Robot-Assisted Partial Cystectomy of a Bladder Pheochromocytoma

Robot-Assisted Partial Cystectomy of a Bladder Pheochromocytoma

Paraganglioma of the urinary bladder

Clinicopathological study of pheochromocytoma of the urinary bladder: Immunohistochemical, flow cytometric and ultrastructural findings with review of the literature

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