# Long-Term Survival of Bifocal Paraganglioma: A Case Report

## TL;DR

A rare case of bifocal paraganglioma in a 52-year-old woman was successfully managed with radiotherapy and surgery, with the patient remaining in good health after 11 years.

## Contribution

This case report highlights the rarity and diagnostic challenges of bifocal paraganglioma and emphasizes the importance of thorough staging.

## Key findings

- The patient had paraganglioma in two locations: the right tympano-jugular region and the mesocolon.
- Radiotherapy and surgical resection were effective treatments, with no recurrence after 11 years of follow-up.
- Nonspecific symptoms made simultaneous diagnosis of both tumor locations difficult.

## Abstract

Paragangliomas are sympathetic and parasympathetic para-ganglia neuroendocrine tumors of the autonomic nervous system.

We analyzed a bifocal paraganglioma case of a 52-year-old patient in December 2013 with hearing loss and right ear pain, headaches, episodes of vomiting, and abdominal pain ten months before her medical consultation. The diagnosis of a right tympano-jugular glomus paraganglioma was based on cerebral magnetic resonance imaging and treated with radiotherapy. In 2016, the patient presented with worsening digestive symptoms; therefore, a second mesocolic localization was suspected by abdominal computed tomography and was histologically confirmed on the resection specimen of the mass. The surgery was the only treatment. After a follow-up of 11 years, the patient remained in good condition.

Paraganliomas are rare tumors, their bifocal location in our patient represents an even rarer entity. Given the nonspecific symptomatology, the diagnosis of the retroperitoneal location simultaneously with that of the head and neck was difficult.

Our objective is to emphasize the staging workup for paraganglioma, although it is mostly a benign tumor with slow growth.