Laryngeal paraganglioma: a case report of neuroendocrine tumor in an unusual site

Laryngeal paragangliomas are an exceptionally rare subtype of head and neck paragangliomas, accounting for less than 2% of all cases. Their nonspecific clinical presentation often mimics more common laryngeal lesions, posing diagnostic and therapeutic challenges. We report a 56-year-old male with a 10-month history of progressive hoarseness, dysphagia, and dyspnea. Examination revealed mild stridor and palpable right submandibular lymph nodes. Contrast-enhanced computed tomography showed an elongated enhancing mass in the right glottic and supraglottic regions, with associated lymphadenopathy. Histopathology demonstrated Zellballen pattern nests of cuboidal cells, and immunohistochemistry confirmed paraganglioma with positivity for CD56, focal SMA, and a Ki-67 index of 4–5%. The patient underwent endoscopic laryngeal microsurgery with submucosal excision and mucosal grafting. Postoperative recovery was uneventful, and he remains recurrence-free under follow-up every six months. Despite their rarity, laryngeal paragangliomas should be considered in the differential diagnosis of vascular laryngeal masses, especially in patients with hoarseness or airway compromise. Accurate diagnosis and tailored surgical excision are essential for optimal outcomes.