Paraganglioma are neuroendocrine neoplasms of the peripheral nervous system. Sympathetic paraganglioma can secrete catecholamines and present clinically with the classical triad of hypertension, palpitations and sweating. However, clinicians must remain astute to other presentations from adrenoceptor-mediated responses of other effector organs. Herein, we report a case of metastatic paraganglioma complicated by intestinal pseudo-obstruction and livedo reticularis.
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