TYPE: Abstract TOPIC: Disorders of the Mediastinum PURPOSE: To report a rare occurance of a paraganglioma in a young male which occupied a critical space in the mediastinum and to discuss literature associated with similar cases. METHODS: The case report was transcribed by using the patient's file to review their data, and surgical notes were reviewed to report significant actions and observations during the procedure. Lastly, a thorough literature review was done to ensure relevant discussion. RESULTS: A 30 year old male, with no significant past history, presented with complaints of a left neck swelling for the last 5 years. A biopsy of cervical lymph node showed a metastatic paraganglioma. The diagnosis of a left carotid body tumor was made after doing a full work up, and was resected by the vascular surgery department. He presented again, 6 months later for evaluation of his thoracic disease, which showed a hypermetabolic mass (4.7x4.6cm) in the right precarinal region adjacent to critical vascular structures. He was diagnosed with a mediastinal paraganglioma, which was resected in a challenging procedure without the use of Cardiopulmonary Bypass that was kept on standby given the risks of the procedure. CONCLUSIONS: The surgery done to resect the mass was successful, without the need of Cardiopulmonary Bypass. The histopathology report that followed confirmed the presence of a recurrent paraganglioma. CLINICAL IMPLICATIONS: This report adds value to the existing limited literature on the cases of paraganglioma, as well as, describes a very rare scenario in which a highly vascular mass in a critical area that was resected without the use of Cardiopulmonary bypass. DISCLOSURE: Nothing to declare. KEYWORD: paraganglioma