Craniocervical Paraganglioma With Numerous Pulmonary Metastases

A 28-year-old man presented with a rare craniocervical paraganglioma with multiple pulmonary metastases manifesting as hearing disturbance, hoarseness, and dysphagia in February 2003. Magnetic resonance imaging depicted a large jugular foramen tumor extending to the deep cervical region. Chest computed tomography revealed numerous small pulmonary nodules. The jugular tumor was totally resected immediately after preoperative embolization. Histological examination revealed paraganglioma. Localized irradiation (54 Gy) and two courses of combination chemotherapy consisting of paclitax-el (80mg/m^2) and gemcitabine (1000mg/m^2) were given. The patient remained well during follow up for 48 months and the number of pulmonary metastases did not increase. Local control of primary craniocervical paraganglioma by palliative surgical resection may be effective for control of metastatic lesions.