Treatment of metastatic carotid body paraganglioma in a young female

Carotid body tumors (CBTs) are rare head and neck paragangliomas that arise from the carotid body chemoreceptor at the common carotid bifurcation. These neoplasms are generally benign, slow-growing, nonsecreting, and well-vascularized. Metastasis occurs in ~5% of cases. Here, we report a case of a 35-year-old female presenting with 1-year history of a growing left neck mass, consistent with a CBT. Patient ultimately underwent surgical excision and was found to have a malignant paraganglioma with metastases to cervical lymph nodes. She was further treated with a left modified radical neck dissection and adjuvant radiotherapy and remains disease-free at the time of follow-up 2 years later. We discuss the roles of preoperative assessment, concomitant selective neck dissection and tumor resection, and subsequent modified radical neck dissection as part of the diagnosis and surgical management of malignant CBTs.