膀胱副神经节瘤5例报告及文献复习

Report of 5 cases of bladder paraganglioma and literature review

目的:探讨膀胱副神经节瘤的疾病特点及诊疗方法。方法:回顾性分析2012年3月~2019年1月在我院诊治的5例术后病理诊断为膀胱副神经节瘤患者的临床资料和随访结果。结果:5例患者均顺利完成手术治疗,术后病理组织表现为免疫组化不同程度的表达[嗜铬粒蛋白A(CgA)、突触素(Syn)、CD56等染色标记为阳性]。术后随访6~40个月,平均26.5个月,术前有血尿、头痛、心悸及排尿后血压升高等症状的患者于术后症状消失或逐渐缓解,5例患者术后均无复发或转移。结论:膀胱副神经节瘤在临床上非常罕见,且易误诊漏诊,需根据术后免疫组化进行明确诊断。其可分为功能性和非功能性,主要依据临床特征及内分泌检查进行鉴别。术前应进行定性和定位的辅助检查,目前膀胱副神经节瘤的治疗方案多样,手术治疗仍是首选方案,治疗后应长期规律随访。

Objective:To explore the characteristics,diagnosis and treatment of bladder paraganglioma.Method:The clinical data and follow-up results of 5 cases of postoperative pathological diagnosis of bladder paraganglioma in our hospital from March 2012 to January 2019 were retrospectively analyzed.Result:All the 5 patients underwent surgical treatment successfully.The postoperative pathological tissues showed different degrees of expression of immunohistochemistry(CgA,Syn,CD56 and other staining markers were positive).All patients were followed up for 6 to 40 months,with an average of 26.5 months.Patients with symptoms of hematuria,headache,palpitation and elevated blood pressure after urinary surgery disappeared or gradually relieved after surgery.Five patients had no recurrence or metastasis after operation.Conclusion:Bladder paraganglioma is very rare in clinical practice and is easily misdiagnosed and missed.It needs to be diagnosed according to postoperative immunohistochemistry.It can be divided into functional and non-functional,mainly based on clinical features and endocrine examination.Qualitative and localized auxiliary examination should be performed before operation.At present,the treatment options for bladder paraganglioma are diverse,and surgical treatment is still the first choice.Long-term follow-up should be followed after treatment.