Metastatic Paraganglioma Presenting as Incontinence in a 15-Year-Old Girl

Chromaffin cell tumors are derived from neural crest cells and can produce and secrete catecholamines. Classic symptoms include headache, palpitations, diaphoresis, and hypertension. Diagnosis is typically in adulthood, and metastatic disease is rarely found. Genetic testing is suggested with young age, extra-adrenal tumors, malignant disease, or family history of associated tumors. Our young patient's presentation of incontinence is unique, but several other atypical findings can be accounted for relative to her germline mutation. Because of the rarity of our patient's case, follow-up procedure is undefined. Documenting atypical cases such as this is central to clinician awareness and development of follow-up protocol.