V1854: ROBOTIC-ASSISTED LAPAROSCOPIC PARTIAL CYSTECTOMY OF BLADDER PHEOCHROMOCYTOMA
VideoIntroduction and Objectives
Bladder pheochromocytoma is an extremely rare disease, occurs less than 0.1% of all bladder tumors. We report a case of bladder pheochromocytoma treated with robotic-assisted laparoscopic surgery.
A 32 years old female presented with severe headache, heart palpitation, diaphoresis and flushing upon urination. In the endocrinologic evaluation, she had a high level of plasma norepinephrine and normetanephrine. An abdominal MRI revealed a 3 cm mass arising from right anterolateral wall of bladder which was hyperintense on T2 fat saturated images. After patient completed a 2-week course of nonselective alpha-blocker preoperatively, patient underwent robotic-assisted laparoscopic partial cystectomy.
Bilateral ureteral stents were inserted due to the tumor close proximity to the ureteric orifices and removed before complete closure the bladder. Dissection and resection of the mass was successfully completed without difficulty. Blood pressure was stable entire the procedure. The operative time was 90 minutes with an estimated blood loss of 50 ml. The patient had an uneventful postoperative period. Hospital stay was 2 days. Postoperative cystogram at 1 week before removal the catheter showed no leakage. Histopathology revealed 3.6 cm paraganglioma of the urinary bladder with negative surgical margins. Patient has been completely asymptomatic since surgery with normalization of norepinephrine and normetanephrine at 3 week after surgery.
Robotic-assisted laparoscopic partial cystectomy is an effective and safe procedure in bladder pheochromocytoma. The resection and suturing can be facilitated by the specific features of the robotic instrument.