Non-functional urinary bladder paraganglioma with negative Ga-DOTA-NOC PET/CT uptake

Abstract

Background Paraganglioma of the urinary bladder is a very rare benign tumor that constitutes less than 0.5% of all bladder tumors. It can be functional and non-functional. Functional tumors present with symptoms of catecholamine excess, and non-functional tumors usually remain asymptomatic. Case presentation Here, we present a case of non-functional urinary bladder paraganglioma in a 36-year-old female who presented to us with a history of intermittent hematuria. The routine hematological and biochemical parameters were within normal limits. Diagnostic computed tomography (CT) revealed a hypervascular lesion in the urinary bladder dome with no significant uptake in gallium-68-labelled-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid peptides-NaI3-octreotide positron emission tomography (DOTA-NOC PET/CT). Histopathology and immunohistochemistry confirmed the diagnosis of paraganglioma. Conclusion We present this case because of the rare location of paraganglioma in the urinary bladder and being non-functional with low/absent somatostatin receptor expression.

Dynamic FDG PET/CT on bladder paraganglioma: A case report

“…In this case, the patient presented with hematuria and urinary retention, symptoms non-specific for BPG but more suggestive for aggressive urothelial carcinoma. A preliminary CT-scan with a delayed urographic phase suggested the presence either of a vascular malformation or a hypervascular solid tumor, situated on the bladder dome, where 40% of PGLs are usually found and could give a suspicion (8)(9)(10).…”

“…Ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are important to identify, localize and morphologically describe the tumor. BPGs are submucosal hypervascular lesions that in up to 40% of cases are located in the bladder dome ( 8 – 10 ). Cystoscopy is substantially limited, mostly being able to exclude mucosal involvement, typical of urothelial lesions, whilst biopsy is contraindicated since could unleash a hypertensive episode in patients without the correct medical treatment ( 11 ).…”