Abstract
INTRODUCTION: A paraganglioma is a rare neuroendocrine neoplasm that may develop at various body sites (including the head, neck, thorax, and abdomen). It is a benign tumor, but in rare cases, it can metastasize to other parts of the body. In less than 30%, this tumor secretes catecholamines. Norepinephrine is dominant in extra-adrenal asymptomatic cases, or its symptoms include headaches, hypertension, or sympathetic paraganglia. The tumor may cause palpitations, excessive sweating, and anxiety. Usually, laboratory tests such as catecholamine tests and imaging tests are used to diagnose it .Surgery is the most common treatment, but there are other treatment options, including radiation therapy, chemotherapy, or targeted therapy. CASE PRESENTATION: We present a 37-year-old female with parietal chest pain, exertional dyspnea, palpitations, and left neck swelling, found to have metastatic paraganglioma diagnosed via biopsy. The patient underwent surgery to remove the tumor, resulting in significant symptom improvement without complications. CLINICAL DISCUSSION: Paragangliomas (PGLs) are neuroendocrine tumors found in ganglia, with head and neck PGL (HNPGL) making up 65-70% of PGL cases. Most HNPGLs are benign, but 6-19% can metastasize, complicating diagnosis and surgical removal due to vascular challenges and potential complications like Horner syndrome and CN damage. CONCLUSION: Paragangliomas can cause varied symptoms, sometimes mimicking other conditions. Rarely, carotid body tumors may metastasize, potentially explaining atypical symptoms alongside classic ones.