Paraganglioma of the urinary bladder may be functional and symptomatic in more than half of the cases, or non-functional tumour as our report case.6 Symptomatic paraganglioma of the bladder may be present with the symptoms of hypertension, headache, palpitations, and hematuria and even up to Micturition syncope. These symptoms are caused by compression and therefore irritation of the tumor in the bladder wall which result in increased catecholamine release during detrusor contraction during micturition, bladder …show more content…
The presence of large polygonal cells with abundant granular cytoplasm arranged in a Zellballen pattern nests surrounded by a fibrous network rich in blood vessels is pathognomonic to paragangliomas. These findings are confirmed by immunohistochemical analysis for neuroendocrine markers, such as positive for chromogranin and synaptophysin but negative for urothelial marker cytokeratin.14 On review of literature, about 5 to-15% of the paragangliomas of the urinary bladder are malignant. Evidence of local invasion or distant metastases is the only help to distinguish between benign and malignant