膀胱副神经节瘤6例临床病理分析

Clinicopathologic analyses of 6 cases of paraganglioma of urinary bladder

目的探讨膀胱副神经节瘤(PUB)的临床病理特征及诊断治疗方法。方法回顾性分析2007年11月至2018年7月我院收治的6例膀胱副神经节瘤患者临床资料,总结分析膀胱副神经节瘤的临床病理特点和诊治要点。结果6例患者中男性1例,女性5例,平均年龄42(23~55)岁,所有患者均为无功能性肿瘤,1例临床表现为尿痛,5例为体检发现膀胱占位。CT增强扫描明显强化。肿瘤均为单发,平均直径1.6(0.8~2.2)cm。1例行腹腔镜膀胱部分切除术,1例行膀胱部分切除术,4例行经尿道膀胱肿瘤电切术。平均手术时间72(35~130)min,平均估计出血量22(10~50)ml。术后病理6例均有阳性表达神经内分泌标志物Cg A、CD56和Syn,而上皮性标志物如CK、CEA等为阴性。术后随访8个月至11年,1例于经尿道膀胱肿瘤电切术(TURBT)术后5年复发,其余5例均无肿瘤复发或转移。结论膀胱副神经节瘤临床罕见,可无明显症状,CT增强扫描结合免疫组化检测可明确诊断,经尿道膀胱肿瘤电切术安全、有效,术后需长期随访。

Objective To investigate the clinicopathological features,diagnosis and treatment of paraganglioma of urinary bladder(PUB).Methods The clinicopathological and follow-up data of 6 patients with paraganglioma of urinary bladder treated during November 2008 and July 2018 in our hospital were retrospectively analyzed.Results The six cases involved 1 males and 5 females with the average age of 42(23-55)years.All cases were nonfunctional neoplasm.All the lesions were solitary with an average diameter of 1.6(0.8-2.2)cm.One case had the symptom of urodynia,the other 5 cases were asymptomatic.CT scan was significantly enhanced.One case underwent laparoscopic partial cystectomy,one case underwent partial cystectomy,and the other 4 cases underwent transurethral resection of bladder tumor(TURBT).The average duration of operation was 72(35-130)min.The average estimated blood loss was 22(10-50)ml.Immunohistochemistry showed neuroendocrine markers(e.g.CgA,CD56 and Syn)were expressed in all cases,while epithelial markers(e.g.CK,CEA)were negative.During the follow-up of 8 months to 11 years,one patient suffered from recurrent tumor 5 years after initial TURBT.The other five cases had no recurrence or metastasis.Conclusions PUB is a rare tumor which has no obvious symptoms.A definite diagnosis can be made by CT scan combined with immunohistochemistry.TURBT was safe and effective.The life-long follow-up of these lesions was indispensable.