title: Unrecognized paraganglioma of the urinary bladder as a cause for basilar-type migraine.
abstract: Extra-adrenal paraganglioma with isolated localization in the urinary bladder is a rare neuroendocrine tumor. Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine due to headache for the past 8 years. As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup. After diagnosis of an extra-adrenal paraganglioma, the patient was scheduled for open partial cystectomy. In consideration of the fact that bladder paraganglioma is an infrequent genitourinary cancer, this case report clearly points out the importance of an exact anamnesis and clinical examination to minimize the probability of misdiagnosis with possible fatal consequences in any case with clinical suspicion of bladder paraganglioma.
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Pichler
authors.forename: Isabel
authors.initials: I
authors.lastname: Heidegger
authors.forename: Gerald
authors.initials: G
authors.lastname: Klinglmair
authors.forename: Alexander
authors.initials: A
authors.lastname: Kroiss
authors.forename: Christian
authors.initials: C
authors.lastname: Uprimny
authors.forename: Rudolf Wolfgang
authors.initials: RW
authors.lastname: Gasser
authors.forename: Georg
authors.initials: G
authors.lastname: Schäfer
authors.forename: Hannes
authors.initials: H
authors.lastname: Steiner
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D020325:Migraine with Aura / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010235:Paraganglioma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D011336:Probability; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D014554:Urination