Multiple Paragangliomas in the Carotid Body, Adrenal and Extra-Adrenal Retroperitoneal Locations

Paragangliomas are chromaffin cell tumors that arise from neural crest cells and are extremely rare. Multiple paragangliomas in different locations of the neck and abdomen in the same patient are highly uncommon. We give the instance of a hypertensive male aged 42 years with a history of breathlessness, chest pain, and excessive perspiration for 10 days. Computed tomography of neck and abdomen revealed solid homogenous intensely enhancing masses in the left adrenal of size 64 x 45 x 52 mm [AP x TR x CC (anteroposterior x transverse x craniocaudal)], left paraaortic region of size 41 x 28 x 29 mm [CC x TR x AP (craniocaudal x transverse x anteroposterior)] and at the division of the left common carotid artery of size 17 x 15 x 11 mm (CC x TR x AP). The patient underwent a diagnostic laparotomy and resected tumors were diagnosed as paragangliomas. The possibility of paragangliomas should always be considered when hypervascular masses are encountered in certain locations of the body. Presence of such a lesion must prompt further imaging of the common sites of paragangliomas for the detection of occult synchronous paragangliomas. Routine screening at timely intervals in patients previously diagnosed with paraganglioma may aid in the earlier detection of metachronous tumors.