膀胱褐色細胞腫の1例

Abstract

A case of pheochromocytoma of the urinary bladder was reported. A 43-year-old man visited us with chief complaint of gross hematuria. The physical examination was essentially negative except for hypertension (150/100 mmHg). IVP demonstrated normal upper urinary tract but a filling defect in the bladder. Cystoscopic examination revealed a non-villous and broad based tumor in the anterior bladder wall. With the diagnosis of bladder tumor transurethral snare resection of the tumor was performed. During the resection blood pressure rose to 254/150 mmHg and dropped to 180/100 mmHg by the injection of phentolamine 5 mg. Catecholamine levels in the 24 hour urine of the following day were abnormally elevated. The histological diagnosis was pheochromocytoma of the urinary bladder. Following the histological report a more detailed history was taken from the patient. For five years he had experienced headache and palpitation after miction and those episodes had gradually increased. The patient was subsequently operated upon and a partial cystectomy was performed. Postoperatively a normal voiding pattern was resumed without spells, but hypertension persisted. A 24 hour catecholamine levels were slightly elevated on the 7th postoperative day. The patient was discharged on the 26th postoperative day. At present he is asymptomatic except for hypertension. The literature was reviewed briefly about pleochromocytoma of the urinary bladder.