A 58-year-old woman presented with a lump on the left side of the neck. Investigations by ultrasound-guided fine needle aspiration, magnetic resonance imaging, and positron emission tomography were all indicative of a diagnosis of a solitary malignant mass with no primary lesion identified. The patient underwent a level I-V leftside selective neck dissection. The histology results reported the mass as a carotid body paraganglioma. These are highly vascular lesions. Paragangliomas have characteristic features on the different imaging modalities; in this case they were atypical. This article reviews the main imaging modalities of paragangliomas and cytologic findings of the fine needle aspiration, which is not often performed for these cases owing to their high vascularity.
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