PMC4220420_01
26-year-old female with accelerated hypertension and elevated serum metanephrines diagnosed with pelvic paraganglioma. CECT abdomen axial cut shows heterogeneously enhancing intraluminal growth (arrow) from the left anterolateral wall of the urinary bladder with predominant intraluminal component.
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F1
Contrast-enhanced computed tomography (CECT) abdomen revealed a large, lobulated, heterogeneously enhancing soft tissue mass measuring 6 x 4.5 x 5 cm in size, arising from the left posterolateral wall of the urinary bladder, with a few non-enhancing areas suggestive of necrosis [Figure 1].
26-year-old female with accelerated hypertension and elevated serum metanephrines diagnosed with pelvic paraganglioma. PET/CT image shows intense tracer uptake and somatostatin receptor expressing lesion (arrow) in the left lateral wall of the urinary bladder.
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F2
Positron emission tomography (PET)/computed tomography (CT) using 68 Ga DOTANOC (111In-DOTA-1-Nal3-octreotide) showed intense tracer uptake (SUVmax 9.8) with somatostatin receptor expression in a large heterogeneously hyperenhancing soft tissue lesion 5 x 6 x 5 cm in size, seen arising from the left posterolateral wall of the urinary bladder [Figure 2].
26-year-old female with accelerated hypertension and elevated serum metanephrines diagnosed with pelvic paraganglioma. Intraoperative image shows tumor arising from the left lateral pelvic wall (arrow) and the bladder appears normal (thin arrow).
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F3
The mass was seen arising from the left lateral pelvic wall closely abutting the urinary bladder [Figure 3].
26-year-old female with accelerated hypertension and elevated serum metanephrines diagnosed with pelvic paraganglioma. Photograph of the cut specimen of the excised mass shows areas of necrosis in its inferior aspect (arrow).
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F4
The mass was dissected meticulously and completely excised [Figure 4].
26-year-old female with accelerated hypertension and elevated serum metanephrines diagnosed with pelvic paraganglioma. Photomicrograph of the tissue on immunohistochemical staining (x10) shows positivity for chromogranin marker, suggestive of pheochromocytoma (arrow).
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F5
Immunostain for synaptophysin, chromogranin, and CD56 were positive, consistent with paraganglioma [Figure 5].