McCrary HC, et al. - In this retrospective cohort study involving 70 patients (mean age 47 [21.1] years), researchers classified succinate dehydrogenase (SDH) germline mutations related to malignant head and neck paragangliomas (HNPGLs), assessed time from diagnosis to malignant tumor identification, described metastases locations and functional status of malignant HNPGLs, and assessed the function of selective neck dissection at the moment of initial surgical resection. Findings revealed that malignant HNPGLs are uncommon, hard to diagnose entities that are usually identified by regional or distant metastasis presence. The findings of this research discovered that malignant HNPGLs were 9% prevalent. A selective neck dissection at the time of tumor excision is beneficial. All patients with HNPGLs that were malignant but 1 had SDH subunit B mutations.