Vaginal paraganglioma is very rare. Most patients first presented irregular heavy menses and abnormal vaginal bleeding. The accurate diagnosis can only be made pathologically. Here we report a case of paraganglioma arising from vaginal wall in a 44-year-old woman who only presented catecholamine-related symptoms. The lesion had negative 99mTc-HYNIC-TOC (hydrazinonicotinyl-Tyr3-octreotide) activity but positive on 131I MIBG scan. Paraganglioma was highly suspected, which was confirmed by pathological and immunohistochemical findings after surgical resection of the lesion.
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