Primary laryngeal paraganglioma with multisystem metastases

RATIONALE: Laryngeal paraganglioma (LP) is a rare neuroendocrine tumor with limited evidence on its metastatic behavior. This case is unique because it describes the diagnostic process, therapeutic decisions, and clinical outcome of LP with multisystem metastases, contributing to a better understanding of its aggressive course and management challenges. PATIENT CONCERNS: The patient presented with progressive dysphagia, which was later accompanied by hoarseness and dyspnea. DIAGNOSES: Clinical examination and imaging revealed a mass involving the larynx. Histopathological and immunohistochemical analyses confirmed LP. INTERVENTIONS: The patient underwent tracheostomy after declining partial laryngectomy. Due to tumor progression 5 months post-surgery and dysphagia, partial laryngectomy with extensive tumor resection was performed. OUTCOMES: Four months postoperatively, recovery was uneventful, with no local recurrence and successful tracheostomy tube removal. However, at 13 months after initial diagnosis (November 22, 2020), multiple systemic metastases were detected in the lungs, pancreas, and subcutaneous tissues. The patient succumbed to systemic failure on February 9, 2021. LESSONS: LP diagnosis relies on combined histopathological and immunohistochemical confirmation. Complete surgical resection is critical for preventing recurrence. Once metastasis develops, the prognosis remains poor, underscoring the importance of early diagnosis and multidisciplinary treatment.