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. 2009 Oct;3(5):E45-8.
doi: 10.5489/cuaj.1160.

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

C-H Chen  1 , Alexander H Boag, Darren T Beiko, D Robert Siemens, Alison Froese, Phillip A Isotalo
Affiliations

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

C-H Chen et al. Can Urol Assoc J. 2009 Oct.

Abstract

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 life-threatening 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.

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Figures

Fig. 1.
Fig. 1.
Paraganglioma component of the composite paraganglioma-ganglioneuroma showing the typical Zellballen growth pattern of paraganglioma (hematoxylin-phloxine-saffron stain, 100× magnification).
Fig. 2.
Fig. 2.
Ganglioneuroma component of the composite paraganglioma-ganglioneuroma containing occasional and prominent ganglion cells (hematoxylin-phloxine-saffron stain, 100× magnification).
See this image and copyright information in PMC

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