An Unusual Case of Gastrointestinal Bleeding

A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrantmass that was confirmed by computed tomography angiogram (CTA), which showed an 8 cm well-defined retroperitoneal vascular mass. 123Iodine metaiodobenzylguanidine (123MIBG) scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paragangliomathat was treated with chemotherapy. This case represents an unusual presentation of a paragangliomaassociated with gastrointestinal ( GI) bleedingand highlights the utility of CTA and 123MIBG in evaluation and treatment.