Drug-associated adverse hepatic reactions could be severe, mostly idiosyncratic, that is; they rarely occur, even if administered in the therapeutic dose and are not detected during developmental phase; any substance could be hepatotoxic, however, some drugs could have a higher potential as non-steroidal anti-inflammatory drugs and among them, diclofenac.

Objective: Present the frequency of atypical histological lineage paragangliomas on a third level hospital. Introduction: Paragangliomas, also known as neuroendocrine tumors, are rare and can appear in distinct places throughout the human body where chromaffin cells are present. Such examples include blood vessels and nerves. Thirty percent are in head and neck compartments; after carotid paragangliomas, the yugulotimpanic follow in frequency and then the vagal ones by 5%. Onlyone percent of paragangliomas located in the head and neck are functional compared with those located in other parts of the body that tend to be functional, most commonly causing hypertension. Methods: An ambispective, observational, descriptive review was conducted, including patients operated on by paraganglioma from 1987 to January 2023; 99.4% were initially diagnosed as carotid origin. Results: A total of 1070 patients were captured. 998 patients were female (93.2%). 1,063 of paragangliomas were carotid (99.3%), 2 were vagal (0.18%), 1 was yugulotympanic (0.09%) and 3 were in other locations (0.28%). One was reported as a Schwannoma. None of the tumors were reported as being hyperfunctional. Conclusion: The angiographic visualization of these lesions can confuse their diagnosis and cause an erroneous follow-up with a poor prognosis, since it is described that vagal paragangliomas recur in 17%.