Bladder wall paraganglioma located using123I-mIBG SPECT and CT imaging

Paragangliomas (PGL) are rare neuroendocrine tumours arising from extra-adrenal paraganglia and consist of specialized neural crest-derived cells (catecholamine-secreting chromaffin cells). Sympathetic paraganglia are distributed along the paravertebral and para-aortic axes so that mostly they are intrabdominal, but they can be found in other organs, such as the bladder1. Primary PGL of the bladder is very rare making up less than 0.05% of all bladder malignancy2. It can appear as clinical symptoms secondary to catecholamine hypersecretion, mass effect or even incidental finding on radiologic imaging. Diagnosis is made from clinical, biochemical and typical imaging features, although bladder paraganglioma is difficult to distinguish radiologically from other bladder lesions3. Combined morfo-functional imaging is required to exactly delineate the extent of the disease and to identify multifocal disease for accurately staging the disease before therapy.