title: Paraganglioma of urinary bladder.
abstract: Paraganglioma of the urinary bladder is extremely rare. In this report of a young man, hypertensive crisis and ventricular arrhythmia was provoked during cystoscopic evaluation of a bladder mass. A diagnosis of pheochromocytoma was considered following detection of high serum and urinary catecholamine levels. A preoperative meta-iodobenzylguanidine scan was, however, negative. The bladder mass was surgically removed following initiation of antihypertensive therapy. Pathological confirmation of extraadrenal pheochromocytoma was established. During a serial follow-up, serum and urine catecholamine levels were persistently elevated. This was explained by abnormalities on fluorodeoxyglucose positron emission tomography scan, which were considered to represent a metastatic malignant neuroendocrine tumour. The patient is on palliative chemotherapy for malignant paraganglioma. This case highlights variable presentation of pheochromocytoma, importance of having a high index of clinical suspicion for early recognition and prompt management and serious adverse consequence of a delayed diagnosis.
authors.affiliation: Division of Endocrinology, Tawam Hospital, Al-ain, Abu Dhabi, UAE. aamalik_06@yahoo.com
authors.forename: Azhar Ali
authors.initials: AA
authors.lastname: Malik
authors.forename: Bachar
authors.initials: B
authors.lastname: Afandi
authors.forename: Gohar
authors.initials: G
authors.lastname: Jamil
authors.forename: Syed M J
authors.initials: SM
authors.lastname: Akhter
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000175:diagnosis; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis
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