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Tumours secreting catecholamine are a known perioperative anaesthetic challenge. However, extra adrenal location of such tumors can cause sudden catastrophe in unprepared patients. A 45 year old, 50 kg female patient scheduled for transurethral cystoscopic resection of bladder tumour of suspected neoplastic aetiology, developed sudden, severe tachycardia, hypertension, and arrhythmias followed by hypotension under general anaesthesia. Tumour biopsy obtained during first surgery confirmeddoi:10.4038/slja.v25i2.8203 fatcat:sc3gr7gjpjgu7aj7jcr4sti2ka