RADIOLOGY: PANCREAS: Case# 33672: PANCREATIC PARAGANGLIOMA. This is a follow-up examination of a 71 year old female with a history of unusual pancreatic neoplasm. The patient has had prior surgery. A 4x4x5.5cm heterogeneous enhancing mass/lesion is seen in the region of pancreatic head displacing the celiac axis and its branches as well as splenoportal system. Immediately cephalad to the mass an intensely round structure is noted which may either represent a tortuous dilated portal vein or perhaps a pseudoaneurysm at the site of prior surgery. There is diffuse fatty infiltration of the liver without any focal lesions. Pneumobilia is present from biliary antric anastomosis. Most functioning paragangliomas (>80%) are found in the adrenal glands and are more commonly called pheochromacytomas. Between 8-16% are found in an extra-adrenal, intra-abdominal site (such as the pancreas). Only 2-4% of extra-adrenal paragangliomas are found within the head and neck.