Paraganglioma of the urinary bladder

Can biologic potential be predicted?

Liang Cheng, Bradley C. Leibovich, John C. Cheville, Dharamdas M. Ramnani, Thomas J. Sebo, Roxann M. Neumann, Antonio G. Nascimento, Horst Zincke, David G. Bostwick

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

BACKGROUND. Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome. METHODS. The Mayo Clinic experience over 53 years with paraganglioma of the bladder was reviewed. All histologic slides from 16 patients were reviewed by the authors. Eight cases were examined immunohistochemically with cytokeratin (AE1/3, cytokeratin 7, and cytokeratin 20), vimentin, S-100 protein, neuroendocrine markers (chromogranin, synaptophysin, and neuron specific enolase), p53 protein, and MIB-1. DNA ploidy was determined by digital image analysis in formalin fixed, paraffin embedded tissue. The mean follow-up was 6.3 years (range, 0.4-16.4 years). RESULTS. Paraganglioma usually occurred in young adult women (mean age, 45 years; range, 16-74 years). The male-to- female ratio was 1 to 3. The common symptoms and signs were hypertension and hematuria. The tumors were usually located intramurally in the lateral and posterior wall of the bladder and were multifocal in 3 cases (18%). Seven patients were treated by transurethral resection, eight by partial cystectomy, and one by radical cystectomy. T classification was T1 (1 patient), T2 (9 patients), T3 (2 patients), and T4b (4 patients). At the time of diagnosis, one patient had distant metastasis and one had regional lymph node metastasis. One patient developed metastasis 1 year after diagnosis and died of the disease 1.5 years later. None of the patients with T1 or T2 tumors had recurrence or tumor progression. All tumors were aneuploid. The mean MIB-1 labeling index was 1.5% (range, 0.03-7.0%). The tumor cells displayed immunoreactivity for S-100 protein and neuroendocrine markers and were negative for p53 (except 1 case) and cytokeratin. CONCLUSIONS. Paraganglioma of the urinary bladder occurs mostly in young adult women. Patients with tumor of advanced classification (≥T3) are at risk of recurrence, metastasis, and dying of the disease, whereas patients in this study with T1 or T2 disease had favorable outcomes after complete tumor resection. (C) 2000 American Cancer Society.

Original languageEnglish
Pages (from-to)844-852
Number of pages9
JournalCancer
Volume88
Issue number4
DOIs
StatePublished - Feb 15 2000

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Paraganglioma
Urinary Bladder
Neoplasms
Neoplasm Metastasis
S100 Proteins
Cystectomy
Young Adult
Keratin-3
Keratin-20
Ki-67 Antigen
Keratin-7
Chromogranins
Recurrence
Synaptophysin
Phosphopyruvate Hydratase
Ploidies
Aneuploidy
Vimentin
Hematuria
Keratins

Keywords

  • Bladder
  • DNA ploidy
  • Ki-67 labeling index
  • Neoplasms
  • p53
  • Paraganglioma
  • Pheochromocytoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cheng, L., Leibovich, B. C., Cheville, J. C., Ramnani, D. M., Sebo, T. J., Neumann, R. M., ... Bostwick, D. G. (2000). Paraganglioma of the urinary bladder: Can biologic potential be predicted? Cancer, 88(4), 844-852. https://doi.org/10.1002/(SICI)1097-0142(20000215)88:4<844::AID-CNCR15>3.0.CO;2-I

Paraganglioma of the urinary bladder : Can biologic potential be predicted? / Cheng, Liang; Leibovich, Bradley C.; Cheville, John C.; Ramnani, Dharamdas M.; Sebo, Thomas J.; Neumann, Roxann M.; Nascimento, Antonio G.; Zincke, Horst; Bostwick, David G.

In: Cancer, Vol. 88, No. 4, 15.02.2000, p. 844-852.

Research output: Contribution to journalArticle

Cheng, L, Leibovich, BC, Cheville, JC, Ramnani, DM, Sebo, TJ, Neumann, RM, Nascimento, AG, Zincke, H & Bostwick, DG 2000, 'Paraganglioma of the urinary bladder: Can biologic potential be predicted?', Cancer, vol. 88, no. 4, pp. 844-852. https://doi.org/10.1002/(SICI)1097-0142(20000215)88:4<844::AID-CNCR15>3.0.CO;2-I
Cheng, Liang ; Leibovich, Bradley C. ; Cheville, John C. ; Ramnani, Dharamdas M. ; Sebo, Thomas J. ; Neumann, Roxann M. ; Nascimento, Antonio G. ; Zincke, Horst ; Bostwick, David G. / Paraganglioma of the urinary bladder : Can biologic potential be predicted?. In: Cancer. 2000 ; Vol. 88, No. 4. pp. 844-852.
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abstract = "BACKGROUND. Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome. METHODS. The Mayo Clinic experience over 53 years with paraganglioma of the bladder was reviewed. All histologic slides from 16 patients were reviewed by the authors. Eight cases were examined immunohistochemically with cytokeratin (AE1/3, cytokeratin 7, and cytokeratin 20), vimentin, S-100 protein, neuroendocrine markers (chromogranin, synaptophysin, and neuron specific enolase), p53 protein, and MIB-1. DNA ploidy was determined by digital image analysis in formalin fixed, paraffin embedded tissue. The mean follow-up was 6.3 years (range, 0.4-16.4 years). RESULTS. Paraganglioma usually occurred in young adult women (mean age, 45 years; range, 16-74 years). The male-to- female ratio was 1 to 3. The common symptoms and signs were hypertension and hematuria. The tumors were usually located intramurally in the lateral and posterior wall of the bladder and were multifocal in 3 cases (18{\%}). Seven patients were treated by transurethral resection, eight by partial cystectomy, and one by radical cystectomy. T classification was T1 (1 patient), T2 (9 patients), T3 (2 patients), and T4b (4 patients). At the time of diagnosis, one patient had distant metastasis and one had regional lymph node metastasis. One patient developed metastasis 1 year after diagnosis and died of the disease 1.5 years later. None of the patients with T1 or T2 tumors had recurrence or tumor progression. All tumors were aneuploid. The mean MIB-1 labeling index was 1.5{\%} (range, 0.03-7.0{\%}). The tumor cells displayed immunoreactivity for S-100 protein and neuroendocrine markers and were negative for p53 (except 1 case) and cytokeratin. CONCLUSIONS. Paraganglioma of the urinary bladder occurs mostly in young adult women. Patients with tumor of advanced classification (≥T3) are at risk of recurrence, metastasis, and dying of the disease, whereas patients in this study with T1 or T2 disease had favorable outcomes after complete tumor resection. (C) 2000 American Cancer Society.",
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T2 - Can biologic potential be predicted?

AU - Cheng, Liang

AU - Leibovich, Bradley C.

AU - Cheville, John C.

AU - Ramnani, Dharamdas M.

AU - Sebo, Thomas J.

AU - Neumann, Roxann M.

AU - Nascimento, Antonio G.

AU - Zincke, Horst

AU - Bostwick, David G.

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N2 - BACKGROUND. Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome. METHODS. The Mayo Clinic experience over 53 years with paraganglioma of the bladder was reviewed. All histologic slides from 16 patients were reviewed by the authors. Eight cases were examined immunohistochemically with cytokeratin (AE1/3, cytokeratin 7, and cytokeratin 20), vimentin, S-100 protein, neuroendocrine markers (chromogranin, synaptophysin, and neuron specific enolase), p53 protein, and MIB-1. DNA ploidy was determined by digital image analysis in formalin fixed, paraffin embedded tissue. The mean follow-up was 6.3 years (range, 0.4-16.4 years). RESULTS. Paraganglioma usually occurred in young adult women (mean age, 45 years; range, 16-74 years). The male-to- female ratio was 1 to 3. The common symptoms and signs were hypertension and hematuria. The tumors were usually located intramurally in the lateral and posterior wall of the bladder and were multifocal in 3 cases (18%). Seven patients were treated by transurethral resection, eight by partial cystectomy, and one by radical cystectomy. T classification was T1 (1 patient), T2 (9 patients), T3 (2 patients), and T4b (4 patients). At the time of diagnosis, one patient had distant metastasis and one had regional lymph node metastasis. One patient developed metastasis 1 year after diagnosis and died of the disease 1.5 years later. None of the patients with T1 or T2 tumors had recurrence or tumor progression. All tumors were aneuploid. The mean MIB-1 labeling index was 1.5% (range, 0.03-7.0%). The tumor cells displayed immunoreactivity for S-100 protein and neuroendocrine markers and were negative for p53 (except 1 case) and cytokeratin. CONCLUSIONS. Paraganglioma of the urinary bladder occurs mostly in young adult women. Patients with tumor of advanced classification (≥T3) are at risk of recurrence, metastasis, and dying of the disease, whereas patients in this study with T1 or T2 disease had favorable outcomes after complete tumor resection. (C) 2000 American Cancer Society.

AB - BACKGROUND. Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome. METHODS. The Mayo Clinic experience over 53 years with paraganglioma of the bladder was reviewed. All histologic slides from 16 patients were reviewed by the authors. Eight cases were examined immunohistochemically with cytokeratin (AE1/3, cytokeratin 7, and cytokeratin 20), vimentin, S-100 protein, neuroendocrine markers (chromogranin, synaptophysin, and neuron specific enolase), p53 protein, and MIB-1. DNA ploidy was determined by digital image analysis in formalin fixed, paraffin embedded tissue. The mean follow-up was 6.3 years (range, 0.4-16.4 years). RESULTS. Paraganglioma usually occurred in young adult women (mean age, 45 years; range, 16-74 years). The male-to- female ratio was 1 to 3. The common symptoms and signs were hypertension and hematuria. The tumors were usually located intramurally in the lateral and posterior wall of the bladder and were multifocal in 3 cases (18%). Seven patients were treated by transurethral resection, eight by partial cystectomy, and one by radical cystectomy. T classification was T1 (1 patient), T2 (9 patients), T3 (2 patients), and T4b (4 patients). At the time of diagnosis, one patient had distant metastasis and one had regional lymph node metastasis. One patient developed metastasis 1 year after diagnosis and died of the disease 1.5 years later. None of the patients with T1 or T2 tumors had recurrence or tumor progression. All tumors were aneuploid. The mean MIB-1 labeling index was 1.5% (range, 0.03-7.0%). The tumor cells displayed immunoreactivity for S-100 protein and neuroendocrine markers and were negative for p53 (except 1 case) and cytokeratin. CONCLUSIONS. Paraganglioma of the urinary bladder occurs mostly in young adult women. Patients with tumor of advanced classification (≥T3) are at risk of recurrence, metastasis, and dying of the disease, whereas patients in this study with T1 or T2 disease had favorable outcomes after complete tumor resection. (C) 2000 American Cancer Society.

KW - Bladder

KW - DNA ploidy

KW - Ki-67 labeling index

KW - Neoplasms

KW - p53

KW - Paraganglioma

KW - Pheochromocytoma

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