Hypertensive crisis of a patient with undiagnosed paraganglioma

Paragangilomas are uncommon catecholamine-secreting neuroendocrine tumors that derived from the autonomic nervous system. Patients with paraganglioma may develop cardiovascular complication such as severe hypertensive crisis during anesthesia or surgery. It can lead to a life threatening condition if undiagnosed preoperatively or not adequately prepared. Paragangiloma and gastrointestinal stromal tumors (GISTs) may have a similar radiographic appearance. If there are no histologic confirmation and clinical manifestation of catecholamine excess, paragangliomas may be mistaken of GISTs. We report the case of a 56-year-old woman who developed hypertensive crisis during anesthesia for GISTs excision.