Pheochromocytoma of the Prostate: An Unusual Location

Dennis, Patrick J.; Lewandowski, A. E.; Rohner, Thomas J.; Weidner, W.; Mamourian, Alexander C.; Stern, Dana

doi:10.1016/s0022-5347(17)40619-7

Cited by 25 publications

(18 citation statements)

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“…1,5,9 The laboratory diagnosis is made by detecting an elevation of the 24-hour urinary total catacholamine and vanillylmandelic acid levels, but can only be used in functional paragangliomas. [2][3][4]8 The diagnosis of non-functional paraganglioma may not be made until an advanced stage due to asymptomatic presentation or nonspecific symptoms. In the reported 5 cases of non-functional prostatic paraganglioma, 2 were unresectable at surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

“…In reviewing the English literature, we found only 7 cases which were preoperatively diagnosed as prostate paragangliomas. [1][2][3][4][5][6][7][8][9] We report an unusual case of a prostatic paraganglioma diagnosed with computed tomography (CT)-guided biopsy, and successfully removed by surgical intervention. We also review related articles with preoperative diagnosis of this rare entity.…”

Section: Introductionmentioning

confidence: 99%

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Extra-adrenal paraganglioma of prostate

Wang

Chen

Kao

et al. 2013

CUAJ

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Extra-adrenal pheochromocytomas, or paragangliomas, are rare tumours that may develop from extra-adrenal chromaffin cells, and most occur in the organ of Zuckerkandl. Extra-adrenal paraganglioma of the prostate is extremely rare. We report a 53-year-old man with hypertension and lower urinary tract symptoms, who was initially diagnosed with benign prostate hyperplasia. Computed tomography (CT) showed a large heterogenously enhancing mass in the prostate, imprinting the right distal ureter and urinary bladder. Before surgical intervention, CT-guided biopsy of the prostatic mass was performed and the result of histologic examination confirmed extra-adrenal paraganglioma. He underwent radical prostatectomy, partial cystectomy and right ureteroneocystostomy. The patient recovered and his blood pressure returned within normal range after surgical removal of the prostate tumour. In this article, we stress that the rarity of prostatic paraganglioma, preoperative localization and imaging-guided biopsy were useful in determining the surgical strategy. IntroductionExtra-adrenal phenochromocytomas are catecholamine-producing tumours that may arise from any site where chromaffin tissue is present. They are most frequently found in the organ of Zuckerkandl (around the root of the inferior mesenteric artery), but it also may be uncovered in other locations, such as retroperitoneum and the urinary bladder. Paragangliomas occurring in the prostate are extremely rare. Clinical presentations are not specific and the classic triad of symptoms (i.e., episodic headache, sweating, and tachycardia) are not common. Therefore, the diagnosis is usually delayed. In reviewing the English literature, we found only 7 cases which were preoperatively diagnosed as prostate paragangliomas. [1][2][3][4][5][6][7][8][9] We report an unusual case of a prostatic paraganglioma diagnosed with computed tomography (CT)-guided biopsy, and successfully removed by surgical intervention. We also review related articles with preoperative diagnosis of this rare entity. Case reportA 53-year-old man with a half-year history of hypertension presented to our clinic because he had difficulty in starting a urine stream, weak flow and dribbling after urination for 1 month. His hypertension was paroxysmal and was well-controlled with anti-hypertension drugs followed at local medical clinics. He was otherwise well, and had no headaches, palpitations, anxiety, flushing, diaphoresis or weight loss.At digital rectal examination, an enlargement of the prostate was palpable. There were no abnormalities on basic blood tests, and his age-adjusted prostate-specific antigen (PSA) level was normal. Ultrasonography of abdomen revealed asymmetrical enlargement of the prostate. Contrast enhanced CT of abdomen and pelvis showed one large, heterogeneously-enhanced mass in the prostate, imprinting the bladder base and right ureterovesical junction, without clear demarcation from the prostate (Fig. 1). No other visceral abnormality was seen. On cystoscopy, a prominence about a ...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extra-adrenal paraganglioma of prostate

Wang

Chen

Kao

et al. 2013

CUAJ

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“…Paraprostatic pheochromocytoma and micturition syncope are both very rare urologic conditions [1,2]. We report a patient with documented micturition syncope due to a paraprostatic pheochromocytoma with bladder wall invasion which, to our knowledge, is the first case reported in the literature.…”

Section: Introductionmentioning

confidence: 82%

Micturition Syncope due to Paraprostatic Pheochromocytoma

Padevit¹,

John²,

Gunz³

et al. 2005

Urol Int

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“…9,10 Rare periprostatic paragangliomas have also been described. [11][12][13] Malignant behaviour has been documented in 5% to19% of bladder paragangliomas 1,4 and there are no reliable histologic criteria to differentiate malignant from benign tumours. 3,4 There is a suggestion that paragangliomas that result in necrosis, mitotic activity and angiolymphatic invasion behave more aggressively.…”

Section: Discussionmentioning

confidence: 99%

Composite paraganglioma-ganglioneuroma of the urinary bladder: a rare neoplasm causing hemodynamic crisis at tumour resection

Chen

Boag

Beiko

et al. 2013

CUAJ

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A 64-year-old man presented with gross painless hematuria. Cystoscopy revealed a submucosal bladder neck mass covered by normal urothelium. During transurethral resection, the patient developed hemodynamic crisis including sinus bradycardia. Histopathologic examination revealed a primary bladder composite paraganglioma-ganglioneuroma (CPG). The patient underwent partial cystectomy and is symptom-free after one year. Bladder CPGs are extremely rare neoplasms that may result in lifethreatening catecholamine secretion, especially during tumour manipulation. These tumours require complete surgical excision and should be included in the differential diagnosis of any solitary bladder mass covered by normal urothelium, especially when there is a history of hypertension or micturition attacks.Can Urol Assoc J 2009;3(5):E45-E48

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Pheochromocytoma of the Prostate: An Unusual Location

Abstract: We report a case of pheochromocytoma of the prostate. The clinical presentation, diagnostic evaluation, therapy and pathological findings are discussed.

Cited by 25 publications

References 1 publication

Extra-adrenal paraganglioma of prostate

Extra-adrenal paraganglioma of prostate

Micturition Syncope due to Paraprostatic Pheochromocytoma

Composite paraganglioma-ganglioneuroma of the urinary bladder: a rare neoplasm causing hemodynamic crisis at tumour resection

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