Natural history of facial paraganglioma with 2 decades of follow-up: A case report and literature review

Objective: To report 20 years of natural history data for a facial paraganglioma and provide a comprehensive review of the existing literature.Patient: 81-year-old female with a remote history of cardiac arrest while under anesthesia who elected to observe her facial paraganglioma for 20 years.Interventions: Observation, clinical documentation, radiographic surveillance.Main outcome measures: Tumor progression, patient symptomatology, and review of management options.Results: The initial presentation of the facial paraganglioma was facial spasm. Over the course of observation, symptoms progressed to include complete facial nerve paralysis, pulsatile tinnitus, and otalgia on the affected side. Radiologic surveillance demonstrated incremental growth and erosion of surrounding structures, including the posterior external auditory canal, stylomastoid foramen, and lateral semicircular canal with near-dehiscence. Twenty-four cases of facial paraganglioma were identified in the extended literature search and are summarized herein.Conclusions: This unique case contributes to the scarce literature surrounding facial paragangliomas by reporting the extended natural history of this disease.