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S3-16
(CP)
PHEOCHROMOCYTOMA OF THE URINARY BLADDER - A CASE REPORT OF AN
UNUSUAL PRESENTATION
Ajaykumar GUNTAKA
1
and Rajendra NERLI
2
1) KLE'S Dr. Prabhakar kore hospital, Department of Urology, Belagavi, INDIA - 2) KLE'S Dr. Prabhakar Kore Hospital,
Department of Urology, Belagavi, INDIA
PURPOSE
Pheochromocytoma of the urinary bladder is a rare tumor that originates from chromaffin tissue of the sympathetic
nervous system associated with the urinary bladder wall. The usual signs are haematuria, hypertension during
micturition together with generalized symptoms due to raised catecholamines. We report an unusual presentation of
bladder pheochromocytoma in an adolescent.
MATERIAL AND METHODS
A seventeen year old male patient was referred to urooncology services of the hospital for the management of an
incidentally detected bladder lesion. The patient was earlier admitted to the hospital for valvular heart disease. The
patient was on antihypertensives and anticoagulants. Routine abdominal sonography done for vague upper abdominal
pain revealed a mixed echoic lesion abutting the left lateral wall and fundus of the urinary bladder. The lesion showed
few specks of calcification. This patient was otherwise asymptomatic for the bladder lesion. CT revealed an ill defined
lesion in the superior, posterior and left lateral wall of the bladder, approximately measuring 6 X 5 cms. This lesion
showed peripheral enhancement in the arterial phase and homogenous enhancement in the delayed venous phase. A
radiological diagnosis of haemangioma of the bladder was made and the patient was prepared for surgery. The patient
was put on Inj Heparin and the oral anticoagulants were withdrawn. The INR was brought down to 1.2.
RESULTS
The lesion was excised with a small bladder margin. Intra-operatively the patient’s blood pressure got elevated to
200/110 mm Hg, however the anaesthesiologist was able to control easily. Histopathological examination revealed this
unusual diagnosis. The imaging too did not give any clue of the catecholamine secreting tumor. Inspite of the huge size
of the tumor the symptoms appeared blunted.
CONCLUSIONS
This case is a classic example of histopathologic surprise.