The highest predictor for metastasis remains mutation in the SDHB gene; other factors implicated include the size of the tumor at the time of presentation, location of the primary tumor, with glomus jugular tumors having higher chances of metastasis when compared with carotid body tumors, and the type of tumor, with sympathetic tumors having a higher chance of metastasis [12]. The gene discussed is SDHB; the disease is carotid body paraganglioma.