A pediatric case of bladder paraganglioma diagnosed following hypertensive headache attacks

Abstract

Pediatric urinary bladder paragangliomas (PGL) are extremely rare and often difficult to diagnose. Here, we report the case of a 10-year-old boy who presented with paroxysmal headache occurring after micturition. Marked hypertension was observed during the attacks, and elevated plasma and urinary catecholamine levels were noted. Imaging revealed a bladder tumor, with significant uptake on ¹²³I-MIBG scintigraphy. After blood pressure control with an α₁-adrenergic blocker, partial cystectomy was performed. Histopathological examination confirmed moderately differentiated bladder PGL. Although pediatric PGLs are often hereditary, the patient had no known genetic abnormalities. The patient’s symptoms resolved postoperatively, with no evidence of recurrence three years postoperatively. If patients present with micturition-associated headaches, urinary bladder PGL should be considered in the differential diagnosis. Measuring blood pressure during headache episodes may provide important diagnostic clues.