Challenges for the Endocrine Surgeon in the Decision-making in Managing Head and Neck Paragangliomas

Head and neck paraganglioma tumors present with a lot of challenges in decision-making for choosing the most appropriate management option for particular patients. We present a young patient who is a 22-year-old lady with neck mass for 7 years duration with a gradual increase. There was a significant family history of a sister dying at 18 years of age due to an unknown cause. She was normotensive, nonfunctional, and had a large neck mass reaching up to the base of the skull. As it was considered inoperable, we explored other treatment options and gave her radiation therapy. The tumor mass reduced 60% in 8 months duration. We have kept her in close follow-up with repeat imaging at 6 months intervals. Conclusion: We need to a tailor-made treatment option for each patient with neck paraganglioma and chose wisely among surgery with or without preoperative embolization and radiation therapy.