The Unseen Storm: Intraoperative Catecholamine Crisis Revealing a Silent Bladder Paraganglioma

Bladder paraganglioma is a rare neuroendocrine tumor that may remain clinically silent and present unexpectedly during surgery. We report a 63-year-old woman with non-specific urinary urgency and frequency found to have a bladder mass. During transurethral resection, severe hypertensive crisis and uncontrollable bleeding occurred, necessitating conversion to open partial cystectomy. Histopathology and immunohistochemistry confirmed bladder paraganglioma with muscularis propria invasion and a low proliferative index. This case highlights the importance of considering paraganglioma in vascular bladder tumors to prevent life-threatening intraoperative complications.