Primary Paraganglioma of the Prostate: A Systematic Review of the Literature for A Rare Entity

Ilias Giannakodimos; Afroditi Ziogou; Alexios Giannakodimos; Evangelia Mitakidi; Konstantinos Tzelepis; Evangelos Fragkiadis; Nikolaos Charalampakis

doi:10.2174/0115748871293735240209052044

Primary Paraganglioma of the Prostate: A Systematic Review of the Literature for A Rare Entity

Rev Recent Clin Trials. 2024 Feb 16. doi: 10.2174/0115748871293735240209052044. Online ahead of print.

Authors

Ilias Giannakodimos¹, Afroditi Ziogou², Alexios Giannakodimos², Evangelia Mitakidi¹, Konstantinos Tzelepis³, Evangelos Fragkiadis⁴, Nikolaos Charalampakis²

Affiliations

¹ Department of Urology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
² Department of Medical Oncology, Metaxa Cancer Hospital, National and Kapodistrian University of Athens, Athens, Greece.
³ National and Kapodistrian University of Athens Department of Urology, Geniko Kratiko Nikaias General Hospital, Athens, Greece Athens Greece.
⁴ Department of Urology, Geniko Kratiko Nikaias General Hospital, Athens, National and Kapodistrian University of Athens, Athens, Greece.

PMID: 38549519
DOI: 10.2174/0115748871293735240209052044

Abstract

Background: Paragangliomas of the urinary tract are exceptionally uncommon, and sporadic case reports of primary paraganglioma of the prostate have been reported in the literature.

Methods: Systematic research in PubMed/Medline and Scopus databases concerning primary prostatic paraganglioma was performed by two independent investigators.

Results: This analysis included 25 adult males, with a mean age of 49.8 ± 22.4 years. 32% of included patients had a history of hypertension. Problems during urination (52%), blood loss (44%), either as hematuria or hemospermia, and catecholamine-related symptoms (36%) comprised the most frequently reported clinical manifestations. Digital rectal examination found a palpable nodule in 36% of patients, while prostatic specific antigen (PSA) was normal in all tested patients. Abdominal ultrasound (44%), computed tomography (44%) and magnetic resonance imaging (28%) helped to identify the primary lesion. 24-hour urine epinephrine, norepinephrine and vanillylmandelic acid (VMA) levels were elevated in 90%, 80% and 90% of included patients. Open surgical excision of the mass was performed in 40%, transurethral resection in 8%, open radical prostatectomy in 24%, transurethral resection of the prostate in 16% and robot-assisted radical prostatectomy in 4% of included patients.

Conclusion: Due to atypical clinical manifestation and scarcity of prostatic paraganglioma, urologists should be aware of this extremely rare entity.

Keywords: Paragnaglioma; neuroendocrine; pheochromocytoma; prostate; tumor; urinary tract.