Malignant paraganglioma of the urinary bladder: Immunohistochemical study of prognostic indicators

Authors: Kovacs, Kalman¹; Bell, C.²; Gardiner, Geoffrey²; Honey, R.³; Goguen, Jeannette⁴; Rotondo, Fabio²

Source: Endocrine Pathology, Volume 16, Number 4, December 2005 , pp. 363-369(7)

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Abstract:

Using various immunohistochemical markers, the objective of our study was to assess whether correlation exists between growth potential of paraganglioma (pheochromocytoma) cells and formation of metastasis. The patient was a 28-yr-old man who presented with intermittent episodes of gross hematuria due to a mass in the urinary bladder. He had no constitutional symptoms to suggest paraganglioma. Histologic, immunohistochemical, and electron microscopic investigation of the surgically removed tissue proved that the tumor was a malignant paraganglioma with metastases in the regional lymph nodes. The immunohistochemical tests were not supportive of high cell proliferation index, indicating that metastases can develop in the absence of rapid multiplication of the tumor cells. Abnormalities in vascular architecture and marked expression of VEGF in the tumor cells may be regarded as prognostic signs to predict the formation of metastases.

Keywords: Extra-adrenal paraganglioma; immunohistochemistry; pathology; prognosis; urinary bladder neoplasms

Document Type: Research article

DOI: http://dx.doi.org/10.1385/EP:16:4:363

Affiliations: 1: Department of Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada, Email: kovacsk@smh.toronto.on.ca 2: Department of Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada, 3: Department of Urology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada, 4: Department of Endocrinology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada,

Publication date: 2005-12-01