A 55-year-old morbidly obese man presented with recurrent lower back pain. Imaging with computed tomography showed a 6 × 6-cm hypervascular mass at the aortic bifurcation, immediately anterior to the iliac arteries, with a central area of focal necrosis (Figure 1). There was no radiological evidence of pelvic lymphadenopathy. Results of urine chemistry studies revealed mildly elevated catecholamine levels, with a norepinephrine level of 89 μg/g of creatinine (reference range, 7-65 μg/g of creatinine) and epinephrine, dopamine, and creatinine levels all within normal limits. The patient denied any history of episodic hypertension, dizziness, palpitations, headaches, or diaphoresis. He also denied any recent fevers, night sweats, or chills and had no history of cancer or irradiation therapy.