Functional urinary bladder paraganglioma in a child presenting with obstructive uropathy: A rare case report

Background Pediatric urinary bladder paraganglioma is an exceptionally rare neuroendocrine tumor arising from chromaffin cells within the detrusor muscle. Due to its rarity and variable presentation, early diagnosis can be challenging, often requiring a high index of clinical suspicion and multimodal evaluation. Case Presentation We report a 12‐year‐old female who presented with hypogastric pain, urinary frequency, and mild dysuria. Initial imaging revealed a bladder mass associated with left‐sided hydroureteronephrosis. Over time, the patient developed episodic hypertension, palpitations, and flushing, suggestive of catecholamine excess. Further evaluation with magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) demonstrated a locally invasive mass involving the bladder wall, vesicoureteric junction, cervix, and upper vagina, without evidence of distant metastasis. Histopathological examination showed nests of polygonal cells arranged in a characteristic Zellballen pattern. Immunohistochemistry was positive for chromogranin, synaptophysin, and S‐100 protein, confirming the diagnosis of paraganglioma. Conclusion This case underscores the diagnostic challenges associated with pediatric bladder paraganglioma and highlights the importance of early recognition, thorough evaluation, and a multidisciplinary approach to ensure optimal management and outcomes.