Objective: To report a case of a multiple paraganglioma with 5 concurrent locations and also describe a complication not found in the literature, spontaneous tumor bleeding. Introduction: The paragangliomas are mostly benign and more frequent in women. Can be multiple, and these are considered as the most likely source of familial origin (30%-35%). The multicentric lesions can occur at different life stages not being necessarily simultaneous, a fact that prevents image exam research to be conclusive for tumor presence or absence. In this way the examination of the family members of patients, specially young ones, diagnosed with multicentric tumors may lead to negative results which doesn’t meant that the disease can be developed at a later time period. Therefore routine examination is not justifiable when symptoms relative to tumor presence are not present. Case report: A female patient of 32 years old complaining of tinnitus and diagnosed with five paragangliomas (jugulo-timpanic, bilateral carotid body and bilateral brachiocephalic trunk) through imaging studies. She reported suffering relatives of paragangliomas. Conclusion: The paper reports a rare case and perhaps unique in the literature, multiple paraganglioma with five locations and discusses difficult choice of treatment and complications.
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