膀胱副神经节瘤1例报告并文献复习

目的提高膀胱副神经节瘤的诊疗水平。方法回顾性分析1例膀胱副神经节瘤患者的临床资料,分析总结该病的临床特征及诊疗经过。患者,男,51岁,排尿后头晕同时血压升高,血儿茶酚胺和尿香草苦杏仁酸明显升高,MRI见膀胱前壁33 mm×27 mm 肿块,膀胱镜检未发现肿瘤。术前考虑膀胱前壁副神经节瘤,完善扩容降压3周以上,行腹腔镜下膀胱部分切除术。结果手术顺利,切除范围包括瘤体及部分膀胱壁,术中生命体征平稳。术后10 d 拔除导尿管,未见排尿时血压升高及头晕。术后病理证实为膀胱副神经节瘤。术后3个月复查,血压正常,盆腔CT未见复发。结论膀胱副神经节瘤术前应做好充分准备,术中预防血压波动导致的高血压危象,腹腔镜下膀胱部分切除术治疗效果满意,术后需定期随访。

Bladder paraganglioma:a case report and literature review

Objective To raise the diagnosis and treatment level of bladder paraganglioma. Methods We retrospectively analyze the clinical data of a case of bladder paraganglioma:a male pa-tient,5 1 years old,was dizzy after micturition with blood pressure increasing,whose blood cate-cholamine and VMA increased obviously.CT and magnetic resonance imaging showed a 33 mm×27 mm lump in the front wall of the bladder.The tumor was not found in bladder through cystoscopy. Considering bladder paraganglioma preoperatively,with sufficient perioperative preparation for over 3 weeks including volumn expansion and stability of blood pressure,laparoscopic segmental cystecto-my of the bladder was performed. Results The operation was successful.Excision scope including tumor tissue and part of the bladder front wall,and vital signs was stable intraoperatively.Catheter removed 10 days after the operation.We did not see elevated blood pressure and dizziness during mic-turition,and postoperative pathology testing was actually a bladder paraganglioma.The patient was followed up for 3 months,blood pressure normal.No tumor recurrence. Conclusions Fully prepa-rations should be made to prevent complications such as hypertensive crisis intraoperatively.The lap-aroscopic resection of the partial bladder to treat a bladder paraganglioma has satisfactory curative effect and regular follow-up after surgery is necessary.