DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.074

Pages: 1179-1182

Head and neck paragangliomas are rare neuroendocrine tumors with potential for metastasis, which defines malignancy according to current WHO classification. A 37-year-old woman presented with altered general condition and dysphonia. Imaging revealed a hypervascular mass at the left carotid bifurcation with vascular encasement, necrosis, and multifocal cervical lesions. Nodal involvement and compression of the internal jugular vein were observed. Thoracoabdominal imaging demonstrated pulmonary and hepatic metastases. Histopathology confirmed metastatic paraganglioma. Aggressive imaging features such as large size, necrosis, vascular encasement, and multifocality should raise suspicion for malignancy. Imaging is essential for staging and detection of metastatic disease.