RARE CERVICAL PARAGANGLIOMAS: DIAGNOSTIC AND THERAPEUTIC CHALLENGES IN THREE CASES

Paragangliomas are rare neuroendocrine tumors arising from extra adrenal paraganglionic tissue derived from neural crest cells. They may develop anywhere from the skull base to the sacrum.Cervical paragangliomas also known as head and neck paragangliomas account for approximately 3% of all paragangliomas and mainly involve the carotid body ,vagal or jugulotympanicregions (1) .These tumors are typically benignbut may exhibit locally aggressive behavior. They are more frequently observed in females , accounting for nearly 67% of cases, and most commonly diagnosed between the third and seventh decade of life (4).Complete surgical resection remains the treatment of choice ;however , the rich vascular supply and proximity to critical neurovascular structures often make surgery high-risk .Radiotherapy represents a viable alternative, although its efficacy may vary. Accurate imaging plays a crucial role in diagnosis, and genetic analysis is essential for patient monitoring and long-term follow up.We report three cases of female patients presenting with painless cervical masses. Imaging confirmed the diagnosis of cervical paraganglioma, and biochemical assessments were performed. Due to tumor size and vascular invasion,surgical intervention was deemed unsuitable,leading to radiotherapy as the preferred therapeutic option. This case series aims to provide an overview of the clinical presentation, diagnostic approach ,and therapeutic strategies for cervical paragangliomas .