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JAMA Oncology Clinical Challenge
July 30, 2020

Flushing, Vomiting, and Abdominal Pain Following Abdominal Ultrasonography

Author Affiliations
  • 1Department of Radiation Medicine, Oregon Health & Science University, Portland
  • 2Department of Pathology, Oregon Health & Science University, Portland
JAMA Oncol. Published online July 30, 2020. doi:10.1001/jamaoncol.2020.0787

A 41-year-old man presented with a 7-month history of episodes of back and abdominal pain associated with nausea, vomiting, and flushing. Immediately following workup with noncontrast abdominal ultrasonography, he experienced intense flushing and vomiting. Subsequent contrast-enhanced magnetic resonance imaging identified a 5-cm thoracic paraspinal mass (Figure, A). Computed tomography–guided biopsy of the paraspinal mass revealed a dense cellular infiltrate on histopathology composed of cells with round nuclei and abundant pale cytoplasm (Figure, B).

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