Malignant paraganglioma of the kidney: a rare surgical case with 3-year disease-free survival.

A 36-year-old woman presented with abdominal pain and a left renal mass on imaging. Laboratory findings showed anemia (Hb 88 g/l), leukocytosis (12.31 × 10/l), and pyuria. Computed tomography (CT) revealed a 14 cm left renal cystic-solid mass suspicious for malignancy. Radical nephrectomy was performed, retrieving a 2600 g tumor. Histopathology demonstrated malignant paraganglioma with expansive growth confined to renal parenchyma. No adjuvant therapy was administered. At 3-year follow-up, surveillance positron emission tomography-computed tomography (PET-CT) confirmed no recurrence or metastasis. Renal paragangliomas represent <1% of such tumors, with malignant variants posing diagnostic and therapeutic challenges. This case underscores surgical resection as definitive management for localized disease and suggests favorable outcomes are achievable without adjuvant treatment in select malignant cases. Long-term surveillance remains critical.