A 36-year-old man presented to the clinic with a 3-month history of an enlarging right-sided neck mass. He had some associated pain in the region but denied any dysphonia, dysphagia, flushing, palpitations, diarrhea, or previous syncopal episodes. He denied a history of tobacco use, chronic alcohol use, or a family history of paragangliomas. Physical examination demonstrated a right-sided level II neck mass measuring approximately 5 cm in anterior-posterior dimension that was tender to touch. Palpation of the neck did not reveal any additional lymphadenopathy. All cranial nerves were functional with particular attention to cranial nerve X: he had symmetric palatal elevation and normal laryngeal function on fiberoptic nasopharyngolar-yngoscopy. The mucosal surface of the entire upper aerodigestive tract was unremarkable.
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