Non-functional bladder paraganglioma in a young patient: conservative management by transurethral resection and diagnostic challenges

Bladder paraganglioma is a rare neuroendocrine tumor, accounting for less than 0.05% of all bladder tumours. Its clinical presentation is often variable, making diagnosis challenging, particularly in non-functional forms. We report the case of a patient with a bladder paraganglioma revealed by recurrent haematuria, in the absence of clinical signs of catecholamine secretion. Transurethral resection enabled complete treatment, although the procedure was complicated by stimulation of the obturator nerve, without a notable incident. Postoperative investigations, including follow-up cystoscopy and urinary metanephrine levels, were unremarkable. This case illustrates the diagnostic challenges associated with non-secretory forms. The diagnosis was confirmed by histological and immunohistochemical analysis, which ruled out urothelial carcinoma. Treatment is based on complete resection, and prolonged surveillance is warranted due to the rare but real risk of recurrence or malignant transformation. Although rare, bladder paraganglioma should be considered in the presence of any atypical bladder mass. Appropriate management and close follow-up are essential to ensure an excellent prognosis.