Title:Primary Paraganglioma of the Prostate: A Systematic Review of the
Literature for A Rare Entity
Volume: 19
Issue: 3
Author(s): Ilias Giannakodimos*, Afroditi Ziogou, Alexios Giannakodimos, Evangelia Mitakidi, Konstantinos Tzelepis, Evangelos Fragkiadis and Nikolaos Charalampakis
Affiliation:
- Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Keywords:
Paraganglioma, pheochromocytoma, prostate, neuroendocrine, tumor, urinary tract.
Abstract:
Background: Paragangliomas of the urinary tract are exceptionally uncommon, and
sporadic case reports of primary paraganglioma of the prostate have been reported in the literature.
Methods: Systematic research in PubMed/Medline and Scopus databases concerning primary prostatic
paraganglioma was performed by two independent investigators.
Results: This analysis included 25 adult males, with a mean age of 49.8 ± 22.4 years. 32% of included
patients had a history of hypertension. Problems during urination (52%), blood loss (44%),
either as hematuria or hemospermia, and catecholamine-related symptoms (36%) comprised the
most frequently reported clinical manifestations. Digital rectal examination found a palpable nodule
in 36% of patients, while prostatic specific antigen (PSA) was normal in all tested patients. Abdominal
ultrasound (44%), computed tomography (44%) and magnetic resonance imaging (28%)
helped to identify the primary lesion. 24-hour urine epinephrine, norepinephrine and vanillylmandelic
acid (VMA) levels were elevated in 90%, 80% and 90% of included patients. Open surgical
excision of the mass was performed in 40%, transurethral resection in 8%, open radical prostatectomy
in 24%, transurethral resection of the prostate in 16% and robot-assisted radical prostatectomy
in 4% of included patients.
Conclusion: Due to atypical clinical manifestation and scarcity of prostatic paraganglioma, urologists
should be aware of this extremely rare entity.
