[Malignant carotid paraganglioma. A case report]

Area of Science:

• Endocrinology
• Oncology
• Head and Neck Surgery

Background:

• Paragangliomas are neuroendocrine tumors originating from neural crest cells.
• Head and neck paragangliomas, particularly carotid body tumors, can exhibit malignant behavior.
• Malignant transformation presents diagnostic challenges due to lack of specific histological markers.

Observation:

• A case of bilateral functional (dopamine-secreting) carotid body paraganglioma is presented.
• The patient underwent successful surgical resection.
• Metastases to bone and liver were diagnosed two years post-surgery, leading to a rapid decline.

Findings:

• Malignant carotid body paragangliomas are uncommon, with clinical presentation being the primary indicator of malignancy.
• Distant metastases typically manifest approximately nine years after initial diagnosis.
• Functional paragangliomas, especially those secreting dopamine, show a higher propensity for malignant behavior.

Implications:

• Long-term patient follow-up is essential for early detection of metastatic disease.
• Scintigraphy can aid in diagnosing metastases when histology is unobtainable.
• Understanding the clinical course and risk factors is vital for effective management of malignant paragangliomas.