{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:05:22Z","timestamp":1792598722019,"version":"4.5.0"},"reference-count":33,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,4,10]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Bladder paragangliomas (bPGLs) account for only 0.06% of all bladder tumours, most commonly presenting with post-micturition syncope and hypertensive crisis. Silent paragangliomas are very rare, and failure to recognise them in the perioperative setting can precipitate a hypertensive crisis in the absence of sufficient alpha-blockade. Here, we describe a case of unrecognised bPGL in a woman with pre-existing hypertension and a single prior episode of haematuria thought to be related to urothelial carcinoma. She was found to have a low-grade non-invasive papillary urothelial carcinoma (potentially the cause of her haematuria) and an unrelated vascular-appearing tumour causing hypertensive crisis and broad complex tachycardia on resection. This was confirmed to be a bPGL on histology for which she underwent definitive management with a partial cystectomy following blood pressure management.<\/jats:p>","DOI":"10.1136\/bcr-2023-259283","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T13:50:51Z","timestamp":1714398651000},"page":"e259283","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Unrecognised paraganglioma of the urinary bladder precipitating hypertensive crisis"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6761-240X","authenticated-orcid":false,"given":"Marina","family":"Youssef","sequence":"first","affiliation":[{"name":"Urological Surgery, Barwon Health, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sewell","sequence":"additional","affiliation":[{"name":"Urological Surgery, Barwon Health, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Grills","sequence":"additional","affiliation":[{"name":"Deakin University School of Medicine, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"2025082700210062000_17.4.e259283.1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1159\/000080841","article-title":"Paraganglioma of the bladder: controversy regarding treatment","volume":"73","author":"Pastor-Guzm\u00e1n","year":"2004","journal-title":"Urol Int"},{"key":"2025082700210062000_17.4.e259283.2","doi-asserted-by":"crossref","first-page":"402","DOI":"10.4103\/0974-7796.152058","article-title":"Paraganglioma of urinary bladder","volume":"7","author":"Priyadarshi","year":"2015","journal-title":"Urol Ann"},{"key":"2025082700210062000_17.4.e259283.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(03)00416-0"},{"key":"2025082700210062000_17.4.e259283.4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/S0140-6736(05)67139-5","article-title":"Phaeochromocytoma","volume":"366","author":"Lenders","year":"2005","journal-title":"The Lancet"},{"key":"2025082700210062000_17.4.e259283.5","doi-asserted-by":"publisher","DOI":"10.5732\/cjc.009.10703"},{"key":"2025082700210062000_17.4.e259283.6","doi-asserted-by":"crossref","first-page":"e2251","DOI":"10.1210\/clinem\/dgaa965","article-title":"Incidence and clinical presentation of pheochromocytoma and sympathetic paraganglioma: a population-based study","volume":"106","author":"Ebbehoj","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082700210062000_17.4.e259283.7","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(83)90116-4"},{"key":"2025082700210062000_17.4.e259283.8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1056\/NEJM195307022490106","article-title":"Pheochromocytoma of the urinary bladder","volume":"249","author":"Zimmerman","year":"1953","journal-title":"New England Journal of Medicine"},{"key":"2025082700210062000_17.4.e259283.9","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1016\/j.urology.2014.11.006","article-title":"Patients with urinary bladder paragangliomas: a compiled case series from a literature review for clinical management","volume":"85","author":"Henderson","year":"2015","journal-title":"Urology"},{"key":"2025082700210062000_17.4.e259283.10","doi-asserted-by":"crossref","first-page":"2811","DOI":"10.1210\/clinem\/dgac427","article-title":"Presentation, management, and outcomes of urinary bladder paraganglioma: results from a multicenter study","volume":"107","author":"Yu","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082700210062000_17.4.e259283.11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5489\/cuaj.1160","article-title":"Composite paraganglioma-ganglioneuroma of the urinary bladder: a rare neoplasm causing hemodynamic crisis at tumour resection","volume":"3","author":"Chen","year":"2009","journal-title":"CUAJ"},{"key":"2025082700210062000_17.4.e259283.12","doi-asserted-by":"crossref","DOI":"10.3390\/jpm12020170","article-title":"The Paris system for reporting urinary cytology: a meta-analysis","volume":"12","author":"Nikas","year":"2022","journal-title":"J Pers Med"},{"key":"2025082700210062000_17.4.e259283.13","doi-asserted-by":"crossref","unstructured":"Katiyar R , Dwivedi S , Trivedi S , et al . 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