Abstract
INTRODUCTION AND IMPORTANCE: Sympathetic paragangliomas are rare neuroendocrine tumors arising from the sympathetic nervous system. CASE PRESENTATION: We present a case of a 48-year-old woman with an extremely rare paraganglioma arising from the cervical sympathetic chain that was presented to the emergency department with symptoms of respiratory insufficiency and dysphagia. Imaging revealed a highly vascularized tumor originating from the jugular fossa. After preoperative embolization, the tumor was successfully surgically resected. CLINICAL DISCUSSION: Post-surgery, the patient had right facial nerve paralysis (House-Brackmann grade VI/V), which improved to grade 2 at three months follow-up, with no evidence of recurrence. A multifaceted approach to this challenging problem was analyzed alongside recent relevant literature. CONCLUSION: This case contributes to refining therapeutic algorithms with minimal complications.