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Background <p>Vagal paragangliomas are rare neuroendocrine tumors of the parapharyngeal space, with a small subset exhibiting malignant behavior. Their diagnosis and management remain challenging owing to anatomical complexity and risk of cranial nerve morbidity.</p> Case presentation <p>We report a 46-year-old Maghrebine woman presenting with severe dysphagia and a right lateral cervical mass. Imaging revealed a 40.2 × 40 × 20.6&#xa0;mm right poststyloid parapharyngeal mass. Surgical excision was performed. Histopathology confirmed metastatic paraganglioma with lymph node involvement, establishing malignancy by current criteria. The patient was referred for adjuvant chemoradiotherapy.</p> Conclusion <p>Malignant vagal paragangliomas require a multidisciplinary approach combining surgery and adjuvant therapies. Genetic testing and long-term follow-up are essential given the risk of metastasis and familial syndromes.</p>

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Malignant paraganglioma of the vagus nerve: diagnostic and therapeutic strategies—a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Messaoudi Karim,
  • Walid Yacine Mohamed Cherif

摘要

Background

Vagal paragangliomas are rare neuroendocrine tumors of the parapharyngeal space, with a small subset exhibiting malignant behavior. Their diagnosis and management remain challenging owing to anatomical complexity and risk of cranial nerve morbidity.

Case presentation

We report a 46-year-old Maghrebine woman presenting with severe dysphagia and a right lateral cervical mass. Imaging revealed a 40.2 × 40 × 20.6 mm right poststyloid parapharyngeal mass. Surgical excision was performed. Histopathology confirmed metastatic paraganglioma with lymph node involvement, establishing malignancy by current criteria. The patient was referred for adjuvant chemoradiotherapy.

Conclusion

Malignant vagal paragangliomas require a multidisciplinary approach combining surgery and adjuvant therapies. Genetic testing and long-term follow-up are essential given the risk of metastasis and familial syndromes.