膀胱副神经节瘤的诊治（附3例报告）  

Diagnosis and treatment of paraganglioma of urinary bladder(report of 3 cases)

作　　者：柯春锦 田继华 杨春光 胡志全[1] KE Chunjin;TIAN Jihua;YANG Chunguang;HU Zhiquan(Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2019年第5期274-277,282,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的总结膀胱副神经节瘤的临床特征和诊治进展。方法报道我院收治的3例膀胱副神经节瘤的病例资料,并复习相关文献。病例1,男,34岁,临床症状为间断性肉眼血尿7月,CT示膀胱顶壁类圆形软组织密度影(3.6 cm×3.9 cm),强化明显,尿脱落细胞荧光原位杂交检测阳性。病例2,男,27岁,症状为间断性肉眼血尿1月伴憋尿时心慌,MRI示膀胱左后壁3.4 cm×3.5 cm占位,左侧盆壁淋巴结肿大,血和尿去甲肾上腺素显著升高。病例3,男,51岁,症状为排尿时头昏10余天,MRI示膀胱后壁3.5 cm×2.7 cm结节灶,血去甲肾上腺素显著升高。结果病例1行经尿道膀胱肿瘤电切术,病理诊断为膀胱副神经节瘤,随访2年无复发。病例2行机器人辅助腹腔镜下膀胱部分切除术,术后症状消失,病理诊断为膀胱恶性副神经节瘤,基因检测显示存在胚系SDHB突变。病例3行腹腔镜下膀胱部分切除术,术后症状消失,病理诊断为膀胱副神经节瘤。结论膀胱副神经节瘤的诊治方法日益丰富,其影像学诊断、手术和药物治疗均取得了长足进步。Objective To summarize the clinical features,diagnosis and treatment of paraganglioma of urinary bladder.Methods Three cases of paraganglioma of urinary bladder were treated.The first case was a 34-year-old male complaining of paroxysmal gross hematuria for seven months.Abdominal computed tomography scan showed a 3.6 cm×3.9 cm mass on dome of the bladder,which showed intense uniform enhancement with contrast study.Chromosome duplications were detected by fluorescence in situ hybridization in urine exfoliated cells.The second case was a 27-year-old male with 1 month history of hematuria and palpitation.MRI scan showed a 3.4 cm×3.5 cm mass on left rear wall of the bladder and enlargement of left pelvic lymph nodes.Significant increase in norepinephrine in blood and urine were found.The third case was a 51-year-old male complaining of dizziness during urination for more than 10 days.MRI scan showed a 3.5 cm×2.7 cm mass on posterior wall of the bladder.Significant increase of norepinephrine in blood was found.Results For the first patient,the diagnosis of paraganglioma was made by pathology following a transurethral resection specimen.Two years after surgery,the patient was still disease-free.The second patient received robot-assisted laparoscopic partial cystectomy and the symptoms disappeared.Pathological diagnosis was malignant paraganglioma,meanwhile gene detection revealed germline SDHB mutations.The third patient received laparoscopic partial cystectomy and the symptoms disappeared.Pathological diagnosis was paraganglioma of urinary bladder.Conclusions The diagnosis and treatment of paraganglioma of urinary bladder have become more extensive,and its imaging diagnosis,surgery and medical treatment have made great progress.

关 键 词：膀胱肿瘤 副神经节瘤 诊断 治疗 

分 类 号：R73[医药卫生—肿瘤]