Introduction: Carotid paragangliomas are usually slowly enlarging and painless lateral neck masses. These mostly benign lesions are often recognised due to their typical location, vessel displacement and intratumoral blood flow, features that are usually observed in different imaging modalities. In differential diagnosis, lymphadenopathies, branchial cleft cysts, salivary gland tumours, schwannomas and aneurysms of the carotid artery should be considered. Case presentation: A 36-year-old male was presented with a lump on the right side of the neck eleven months after being treated for testicular cancer. He was referred for fine-needle aspiration biopsy. The sample was diagnosed as a lymph node metastasis of a teratoma component of the germinal tumour or of another primary tumour. Performed neck US and fluorine [F-18]-fluoro-deoxy-Dglucose (FDG) PET-CT showed no signs of hypervascularity or vessel displacement. A functional neck dissection of levels II through V was planned. During the procedure, a suspicion of carotid paraganglioma was raised, and the tumour was carefully dissected from the walls of both carotid arteries with minimal blood loss. The histology report revealed carotid paraganglioma with no metastasis in the rest of the lymph nodes. Conclusion: This is a case of carotid paraganglioma over-treatment by neck dissection performed in a patient previously diagnosed with testicular germ cell tumour
